Beginning in 2022, the recently-passed No Surprises Act will shield consumers from any unexpected bills originating from an out-of-network provider, out-of-network facility, or out-of-network air ambulance provider. This includes most emergency care and many instances of non-emergency care. It also creates an independent dispute resolution process for payment disputes between plans and providers, as well as new dispute resolution options for uninsured and self-pay patients who receive medical bills that are much higher than the provider's good faith estimate.
Prior to the No Surprises Act, if you had health insurance and received care from an out-of-network provider or facility, your health plan might not have covered the total out-of-network cost, even if you didn't realize it. This could have resulted in higher costs than if you had received care from inside your network. Unless state law prohibits it, the out-of-network provider or facility could bill you for the difference between the invoiced fee and the amount your health plan paid, in addition to any out-of-network cost sharing you may have owed.