On Jan. 1, 2022, the No Surprises Act (NSA) went into effect to offer patient families new billing protections when getting emergency care, scheduled visits from out-of-network providers at in-network facilities and all scheduled visits for uninsured patient families.
Specifically, the NSA protects out-of-network patient families from getting surprise medical bills for emergency services and restricts unexpected out-of-pocket costs for scheduled services for both out-of-network and uninsured families. It also removes families from payment disputes between a provider or facility and their health plan.
Surprise billing can occur when you can’t control who is involved in your care. For example, when you have an emergency or you schedule a visit at an in-network office sometimes you are unexpectedly treated by an out-of-network provider. In these circumstances under the NSA, you’re only responsible for paying your share of the cost (i.e. copays or deductibles) that you would normally pay if the provider were in-network.
In addition, the NSA requires that Akron Children’s contacts patients who are out of network or uninsured to inform them of their estimated cost of care. Out-of-network patients who decide to keep their scheduled appointment will be required to sign a financial consent form. Patient families who do not sign the financial consent will be directed to check with their insurance to find an in-network provider.
Uninsured patients will not be required to sign financial consent. They will, however, be asked to sign an acknowledgement that they received the estimate.
For all patient families, MyChart offers the ability to request cost of care estimates for any type of visit or procedure, including well checks or sick visits, surgical procedures, radiology or lab testing. They also can pay their medical bills online via MyChart or as a guest if they don’t have an account.
For more information on the No Surprises Act, review the NSA disclosure, call 1-800-985-3059 or visit www.cms.gov/nosurprises.
