No Surprise Bill Act
The new “No Surprises Act” is designed to protect consumers from most unexpected medical charges from out of network providers. This bill will go into affect this year.
Our billing policies at South Shore ER are designed to eliminate any surprise billing, therefore we’ve aligned with this new bill, even before the new bill is in effect. At South Shore ER, we understand medical emergencies are always a major source of stress to our patients. Your medical bill should not be another burden. We will do our best to protect our patients from balance billing and surprised billings.
However, no matter how hard we try, we cannot control everything the insurance companies do. But, we have complete control over our billing department. We are able to resolve most billing issues to your satisfaction.
Our #1 goal is to make sure you and your family receive THE best medical care without factoring in finances.
According to CMS.gov, “As of January 1, 2022, consumers have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs are restricted, and emergency services must continue to be covered without any prior authorization, and regardless of whether or not a provider or facility is in-network.”
The Surprise Bill protects patients from receiving surprise medical bills resulting from gaps in coverage for emergency services and certain services provided by out-of-network clinicians at in-network facilities. It allows providers and insurers to access an independent dispute resolution process in the event disputes arise around reimbursement.
Most of all the bill allows patients to seek medical attention without any financial concerns.
This bill work hand and hand with Texas prudent layperson standard to allow patients to choose even out of network facilities for their emergency care. Your insurance company cannot force you to go to an in-network ER. They are also not allowed to determine if your symptoms were those of a medical emergency or not.
In other words, if you feel you are having a medical emergency and need to go to the closest ER, your insurance provider is legally obligated to cover your care.
Here at South Shore ER, you will NEVER get a surprise bill. All services provided at our facilities, will show in the invoice we provide you after your visit. You may receive a bill from the physician company who took care of you while in the ER.
If you ever receive a surprise bill from your insurance company after visiting our ER, please contact us immediately.
If you have any questions or concerns regarding this matter, please call us at (281) 713 4200.