No Surprise Act designed to prevent surprise medical bills, but there are some exceptions

The Kaiser Family Foundation estimates the No Surprises Act will apply to as many as 10 million surprise medical bills every year.

Nydia Han Image
Tuesday, March 8, 2022
No Surprise Act designed to prevent surprise medical bills
"For most, The No Surprise Act means you'll no longer receive an unexpected medical bill because you were treated by a doctor or went to a medical facility you didn't choose in the first place," said Lisa Gill of Consumer Reports.

PHILADELPHIA (WPVI) -- Medical bills are the most common debt in collections reported on our credit reports.

Federal data showing the total outstanding amount stands at around $88 billion, and while a new law is designed to help, there are exceptions that you need to prepare for before you end up needing medical attention.

"For most, The No Surprise Act means you'll no longer receive an unexpected medical bill because you were treated by a doctor or went to a medical facility you didn't choose in the first place," said Lisa Gill of Consumer Reports.

That's right no more surprise bills from emergency room doctors or other out-of-network hospital providers, like anesthesiologists and radiologists, when you get care at an in-network facility.

The Kaiser Family Foundation estimates the No Surprises Act will apply to as many as 10 million surprise medical bills every year.

But the law has a few glaring holes. Urgent care visits are only covered if the facility is licensed as an emergency service provider. So how do you know that?

"It's really best if you prepare ahead of time and call several in your area and ask if they're licensed to provide emergency medical services," said Gill.

And then there are lab tests at your regular doctor's office. Be sure you use a lab that's in-network. Again, do your homework beforehand to avoid surprises.

"Since the law is pretty new, hospitals and providers are still adjusting to the new rules, which means they could accidentally send you a medical bill," she said.

If that happens, contact your insurance company to see what's going on. And be prepared to call your provider they might have to resubmit the claim for full coverage.

And if that doesn't work, you can file a federal complaint online at CMS.gov.

If you need further help with a surprise medical bill, contact the Patient Advocate Foundation. They may be able to help you for free. And there are now proposals to change the system so that medical bills at least don't appear on credit reports.

Consumer Financial Protection Bureau: Estimates $88 Billion in Medical Bills on Credit Reports