HARRISBURG (TNS) — A new federal law protects people from paying higher costs because they unknowingly received care from a health care provider from outside their health insurance network.
The No Surprises Act, which took effect Jan. 1, prevents patients from being billed extra in situations such as when they receive emergency care at a hospital or from a doctor considered out-of-network.
It further protects them from having to pay higher out-of-network costs in situations where they’re using an in-network provider, but unknowingly receive care from an out-of-network doctor or provider such as an anesthesiologist or radiologist.
The Pennsylvania Insurance Department is publicizing the new protections and also offering to help people who believe they have been wrongly billed.
That includes protecting them from so-called “balance billing,” where a medical provider attempts to collect the difference between the out-of-network price and what the insurer is willing to pay.
“The implementation of the No Surprises Act is a huge step toward ending unexpected and all-too-often financially devastating medical bills,” state insurance Commissioner Jessica Altman said. “The Insurance Department is committed to protecting patients from balance billing and stands ready to assist consumers and insurers in navigating this new legislation.”
The law will further prevent patients from being caught in the middle of a situation where they have to figure out why they are being billed extra and whether they must pay, according to the insurance department.
“The primary concern following major medical procedures should be recovery, not worry over medical billing,” Altman said.
The insurance department says people who receive an unexpected bill after Jan. 1 which they believe violates the law should call the insurance department at (877) 881-6388 before paying the bill.
People can also have the insurance department review the bill by going to www.insurance.pa.gov/NoSurprises.