Surprise bills occur when patients receive bills for services they thought were covered by their insurance plan.
The No Surprises Act offers several protections from surprise bills. But the new law comes with two important watch-outs and a loophole insurance companies may use to eliminate your protections. Waiving Protection from Surprise Bills Surprise bills often come from an out-of-network provider you didn’t know was out-of-network. The No Surprises Act has some protections for […]
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As of January 1st you are protected from certain Surprise Bills thanks to the No Surprises Act. The good news is that the less-talked about Consolidated Appropriations Act (CAA) gives you protection from surprise bills in two other ways. Consolidated Appropriations Act First, let’s understand a few important things about the CAA. The Act applies
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The No Surprises Act (NSA) became effective January 1st. This bill protects consumers from most out-of-network surprise bills. That’s good news for you. There is bad news for insurance companies. The American Medical Association (AMA) and American Hospital Association (AHA) sued the federal government over the bill’s Independent Dispute Resolution (IDR) process. What is Independent
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The No Surprises Act (NSA) is designed to protect patients from surprise bills. Yet the NSA excludes ground ambulance charges even though at least one study found about half of these rides among privately insured consumers may result in a surprise bill. The Ambulance Industry’s Complexity Why would the NSA exclude ground ambulance charges? In a
Why the No Surprises Act Offers No Relief for Ground Ambulance Costs Read More »
Insurance is complicated. Surprise bills are all too common. Let’s look at six things to help you avoid surprise bills. 1. Enroll a Newborn Within 30 Days Most plans will cover a newborn under the mom’s plan for the first 30 days. But coverage for the baby ends after 30 days. To continue your baby’s
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You learned in my last post that providers can ask you to waive your balance billing and cost sharing protections under the No Surprises Act. To do so, however, facilities must meet specific requirements. Here’s what you need to know in order to make the best decision for you. Facility Notice & Consent Requirements In
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In my February post I summarized the No Surprises Act that is going into effect January 2022. The Act’s main objective is to protect patients from huge surprise bills for certain out-of-network charges. Patients will only have to pay in-network rates for covered out-of-network charges. I said I would update you as significant milestones
First Rule Issued for the No Surprises Act Read More »
Last December Congress passed the No Surprises Act. The law’s intent is to prevent surprise bills for a number of out-of-network medical services. As I said in my post last February, the devil will be in the details. The devil and his devilish details are here. Reimbursement Rates The devilish details start with how
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In 2020 Congress passed two laws to protect consumers from COVID-19 charges. So you might think you don’t need to worry about COVID-19 surprise bills. You would be wrong. Rather than helping patients, some emergency rooms and doctors used the laws to enrich themselves. They overcharged insurance companies and consumers. Here are just two examples:
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The No Surprises Act was passed by Congress last December. It’s set to go into effect in early 2022. That’s great news because the bill is aimed at stopping certain types of surprise medical bills. Like the bill you get from an out-of-network (OON) doctor in an in-network facility. Or an emergency room bill from
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