Your Rights and Protections Against Surprise Medical Bills

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What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs,
like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the
entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s
network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health
plan to provide services. Out-of-network providers may be allowed to bill you for the difference
between what your plan pays and the full amount charged for a service. This is called “balance
billing.” This amount is likely more than in-network costs for the same service and might not
count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is
involved in your care—like when you have an emergency or when you schedule a visit at an in-
network facility but are unexpectedly treated by an out-of-network provider. Surprise medical
bills could cost thousands of dollars depending on the procedure or service.

 

You’re never required to give up your protections from balance billing. You also aren’t
required to get out-of-network care. You can choose a provider or facility in your plan’s
network.

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If you think you’ve been wrongly billed, contact:
On-site Medical Services Compliance: akeady@on-sitemedservices.com
The federal phone number for information and complaints is: 1-800-985-3059
Visit: www.cms.gov/nosurprises/consumers