No Surprises Act

What does No Surprises Act mean on a medical bill?

The No Surprises Act is a federal law that took effect in 2022. It deals with certain out-of-network bills — mainly emergency care and out-of-network providers working at in-network facilities — and it also created a written estimate for people paying without insurance. Where it applies, the provider and the plan settle the difference between themselves through their own process instead of through the patient, and there is a federal complaint path for bills people believe it covers. What it covers turns on the type of care and where it happened, so ask the provider which rule they billed under.

What should I watch out for with No Surprises Act?

• Ask the provider whether the visit was billed as emergency care, since much of the law turns on that answer
• Ask your plan to reprocess a claim from a provider you did not choose at an in-network hospital
• Keep the date, the facility, and the provider group together, because a complaint or an appeal starts with which visit you mean