No Surprises Act
Compliance

Your Rights and Protections Against Surprise Medical Bills

When you receive emergency care or are treated by an out-of-network provider at certain facilities, you are protected from surprise billing under federal law known as the No Surprises Act.

What is “balance billing?”

Balance billing happens when an out-of-network provider bills you for the difference between their charge and what your insurance plan pays. Under the No Surprises Act, you are protected from balance billing in certain situations.

You are protected from balance billing for:

• Emergency services, even if you receive care from an out-of-network provider

• Certain non-emergency services provided by out-of-network providers at in-network hospitals, hospital outpatient departments, or ambulatory surgical centers, unless you give written consent

In these situations, you are only responsible for paying your plan’s in-network cost-sharing (such as copayments, coinsurance, and deductibles).

What you can expect:

• You cannot be balance billed for covered services in protected situations

• Your health plan will pay out-of-network providers directly

• Any payment disputes between providers and insurers must go through an independent resolution process

What this law does not apply to:

• Routine outpatient visits at independent clinics

• In-network services

• Self-pay or uninsured services

• Medicare, Medi-Cal, or other Medicaid programs

If you believe you have been wrongly billed:

You may contact the U.S. Department of Health and Human Services at
1-800-985-3059 or visit www.cms.gov/nosurprises

This notice is provided in compliance with the No Surprises Act.