Understanding the Services Covered by the No Surprises Act

Healthcare can be a complex and costly industry to navigate, especially when unexpected medical bills come into play. To address this issue, The No Surprises Act was signed into law in 2020, providing protections for patients from surprise medical bills. But what exactly does this act cover in terms of services? In this article, we will explore the types of services that fall under the umbrella of The No Surprises Act.

Emergency Services

One of the key provisions of The No Surprises Act is its protection for patients who receive emergency medical care. Under this law, patients cannot be billed more than their in-network cost-sharing amount for emergency services, regardless of where the care was provided. This means that if you require emergency medical treatment at an out-of-network facility, you will only be responsible for the same amount you would have paid if you had received care from an in-network provider.

Examples of emergency services covered under The No Surprises Act include:

  1. Emergency room visits
  2. Ambulance services
  3. Critical care services

Air Ambulance Services

In addition to emergency services, The No Surprises Act also extends protections to patients who require air ambulance services. Air ambulances are often used in cases where patients need to be transported quickly to a medical facility that is not accessible by traditional ground transportation. These services can be lifesaving, but they can also come with hefty price tags. Under The No Surprises Act, patients who receive air ambulance services cannot be billed more than their in-network cost-sharing amount, providing much-needed relief for individuals facing unexpected medical bills.

Non-Emergency Services

While The No Surprises Act primarily focuses on emergency and air ambulance services, it also offers some protections for patients who receive non-emergency care from out-of-network providers. In these cases, patients can only be billed the in-network cost-sharing amount for their services, helping to prevent surprise medical bills from piling up.

Examples of non-emergency services covered under The No Surprises Act include:

  1. Lab tests
  2. Radiology services
  3. Physical therapy

What to Do If You Receive a Surprise Medical Bill

Even with the protections provided by The No Surprises Act, some patients may still find themselves facing unexpected medical bills. If you receive a surprise bill for services that you believe should be covered under this law, there are steps you can take to dispute the charges and seek resolution.

Here are some tips for handling surprise medical bills:

  1. Review your bill carefully to ensure that the charges are accurate.
  2. Contact your insurance company to discuss the charges and determine if the services should have been covered.
  3. Reach out to the healthcare provider or facility that issued the bill to seek clarification and discuss potential payment options.
  4. If you are unable to resolve the issue on your own, consider reaching out to a consumer advocacy organization or legal aid group for assistance.

Conclusion

The No Surprises Act provides important protections for patients who receive emergency, air ambulance, and non-emergency services from out-of-network providers. By limiting the amount that patients can be billed for these services, this law helps to prevent surprise medical bills and alleviate financial burdens for individuals seeking healthcare. If you find yourself facing unexpected charges for services covered under The No Surprises Act, be sure to take proactive steps to dispute the bills and seek resolution.

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