Before the No Surprises Act, if you had health insurance and received care from an out-of-network provider or an out-of-network facility, your health plan may not have covered the entire out-of-network cost. This could have left you with higher fees than if you got care from an in-network provider or facility. In addition to any out-of-network cost-sharing you might have owed, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid unless banned by state law. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also a surprise medical bill.
People with Medicare and Medicaid already enjoy these protections and are not at risk for surprise billing.
No Surprises Act – Machine Readable Files
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