Website Helps People with Unexpectedly High Medical Bills

The Centers for Medicare and Medicaid Services has a new online guide for fighting illegally high medical bills. (Screenshot)

Patients are protected from “surprise” medical bills when they seek care within their insurance network but unknowingly get treated by a more expensive out-of-network provider. Now there is a website to help them understand their rights and use those protections.

The Centers for Medicare and Medicaid Services unveiled an online guide, cms.gov/medical-bill-rights, last week. The site outlines the legal rights for those with and without insurance. Visitors can also get a step-by-step “action plan” for challenging a surprise bill that’s based on their specific experience.

The federal “No Surprise Act,” co-sponsored by Sen. Maggie Hassan, prohibits providers from billing patients at out-of-network rates when they seek care from providers in their network. When the law took effect in January 2022, Hassan said in a statement that several constituents had told her they’d been surprised by unexpectedly high bills. 

One man, she said then, sought treatment after cutting his finger while making dinner. He went to an in-network hospital but was treated by an independent contractor whose services were not covered by his insurance. As a result, he received a $3,500 bill that was much higher than the in-network cost he expected. 

Those who have insurance are protected from out-of-network charges for emergency room visits, non-emergency care at an in-network hospital, hospital outpatient department, and ambulatory surgical center, and when receiving air ambulance services.

For patients without insurance, providers must provide a “good faith” estimate of how much care will cost. Patients may be able to dispute a bill if it’s at least $400 more than the estimate, according to the Centers for Medicare and Medicaid Services site.

This story is courtesy of NH Bulletin under creative commons license. No changes have been made to the article.