The No Surprises Act Offers Hope To Patients With And Without Health Insurance

“Don’t get sick” is the most cynical piece of personal finance advice but also the wisest.  Medical debt has ruined more Americans’ finances than any other kind of debt.  Even the most financially cautious people, the ones who would never enroll at a university that cost more than their scholarships and savings would pay for and would never buy a house unless they could pay for it in cash, can get thrown for a loop if they have to seek emergency medical treatment because of an accidental fall or severe abdominal pain that might be appendicitis.  Insured patients fare better than uninsured patients in such situations, but even patients with health insurance can receive bills for hundreds, or even thousands, of dollars, if providers who weren’t in their network treated them during their ER visit.  (Not all the doctors and radiologists at the same hospital accept payment from the same insurance companies.)  The No Surprises Act, which will take effect at the beginning of next year, will protect both insured and uninsured patients from outsized medical bills.  It cannot make existing medical bills disappear, but a Miami debt lawyer can help with that.

No Surprises for Insured Patients

Pursuant to the No Surprises Act, which will go into effect on January 1, 2022, healthcare providers, including doctors, air ambulance companies, and radiologists, among others, cannot bill patients outside their insurance networks for higher amounts than they charge in-network patients for the same services.  This rule applies when the providers treat patients on an emergency basis, such as in hospital emergency rooms.  Once the patient has received a bill for a comparable amount to what their own insurance companies would charge them, it is up to the provider to negotiate with the patient’s insurance company to determine how much the insurance company will pay.  The No Surprises Act provides for an arbitration process through which the healthcare providers and the insurance companies will negotiate.  The process for companies to register as No Surprises Act arbitrators is currently open.

Arbitration for Uninsured Patients

Uninsured patients will also be able to benefit from the No Surprises Act because the arbitration process for negotiating the settlement amount of medical bills is also open to them.  Any patient who receives a medical bill in excess of $400 will be able to negotiate to settle the bill for a lower amount, using the same arbitration process that insurance companies will use to negotiate with out of network healthcare providers.  Uninsured patients will be responsible for paying $25 to participate in the arbitration process.  The No Surprises Act is not a panacea for America’s medical debt crisis, but it does take steps toward making healthcare more affordable for patients with and without health insurance.

Take Charge of Your Medical Debt With a Debt Lawyer

A South Florida debt lawyer can help you make your astronomical medical bills more manageable through debt consolidation, debt settlement, or other solutions.  Contact Nowack & Olson, PLLC in Miami, Florida to discuss your case.

Resource:

khn.org/news/article/surprise-billing-rule-puts-a-thumb-on-the-scale-to-keep-arbitrated-costs-in-check/