Vladimir Posted February 18 Report Share Posted February 18 The last year of the Trump Administration the No Surprises Act passed Congress. It is worthwhile for RV'ers to understand the law. It provides protection from "surprise medical costs", particularly for emergency care. It puts limits on hospitals and medical communities on HOW they charge for medical care without prior disclosure. See this thread for my adventures with the medical system over $51. It turns out that my medical provider, simply made my doctor "out of network" for a physical IF there was a Medicare coverage. They actually set up TWO addresses for my doctor. One in network and one outside network and billed to maximize their revenue flow. With the No Surprises Act, they HAVE to tell me PRIOR to my appointment that for the purposes of my annual physical, I was "out of network". Well, that ended the scam. Nobody would agree to a insurance plan where being "in-network" or "out-network" is a event designed to maximize revenue to the medical facility. Everybody, should read the No Surprises Act and understand it. There are news reports that some medical providers are NOT following the law. Here is a brief synopsis from the other thread. Anyway here is some text from the government on the Act. What are surprise medical bills? Before the No Surprises Act, if you had health insurance and received care from an out-of-network provider or an out-of-network facility, even unknowingly, your health plan may not have covered the entire out-of-network cost. This could have left you with higher costs than if you got care from an in-network provider or facility. In addition to any out-of-network cost sharing you might have owed, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid, unless banned by state law. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also called a surprise medical bill. People with Medicare and Medicaid already enjoy these protections and are not at risk for surprise billing. What are the new protections if I have health insurance? If you get health coverage through your employer, a Health Insurance Marketplace®, or an individual health insurance plan you purchase directly from an insurance company, these new rules will: Ban surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand (prior authorization). Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services. Ban out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) furnished by out-of-network providers as part of a patient’s visit to an in-network facility. Require that health care providers and facilities give you an easy-to-understand notice explaining the applicable billing protections, who to contact if you have concerns that a provider or facility has violated the protections, and that patient consent is required to waive billing protections (i.e., you must receive notice of and consent to being balance billed by an out-of-network provider). Quote Link to comment Share on other sites More sharing options...
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