You\u2019re never<\/u> required to give up your protections from balance billing. You also aren\u2019t required to get care out-of-network. You can choose a provider or facility in your plan\u2019s network.<\/strong><\/p>\n\n\n\nWhen balance billing isn\u2019t allowed, you also have the following protections:<\/h3>\n\n\n\n
You are only responsible for paying your share of the cost (like the copayments, coinsurance and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.<\/p>\n\n\n\n
Your health plan generally must:<\/p>\n\n\n\n
Cover emergency services without requiring you to get approval for services in advance (prior authorization).<\/p>\n\n\n\n
Cover emergency services by out-of-network providers.<\/p>\n\n\n\n
Base what you owe the provider or facility (cost-sharing) on what it would pay an in\u2011network provider or facility and show that amount in your explanation of benefits.<\/p>\n\n\n\n
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.<\/p>\n\n\n\n
If you believe you\u2019ve been wrongly billed<\/strong>, you may contact the following:<\/p>\n\n\n\nFederal: Call the No Surprises Help Desk at 1-800-985-3059, file a complaint online at www.cms.gov\/nosurprises\/consumers\/complaints-about-medical-billing or start a dispute online at www.cms.gov\/nosurprises\/consumers\/medical-bill-disagreements-if-you-are-uninsured.<\/p>\n\n\n\n
Visit www.cms.gov\/nosurprises\/consumers for more information about your rights under federal law.<\/p>\n","protected":false},"excerpt":{"rendered":"
Click below to download our Good Faith Estimate form. Good Faith Estimate Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. What is \u201cbalance billing\u201d (sometimes called…<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","schema":"","fname":"","lname":"","position":"","credentials":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":""},"service_tags":[],"_links":{"self":[{"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/pages\/3158"}],"collection":[{"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/comments?post=3158"}],"version-history":[{"count":21,"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/pages\/3158\/revisions"}],"predecessor-version":[{"id":3205,"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/pages\/3158\/revisions\/3205"}],"wp:attachment":[{"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/media?parent=3158"}],"wp:term":[{"taxonomy":"service_tags","embeddable":true,"href":"https:\/\/www.entofathens.com\/wp-json\/wp\/v2\/service_tags?post=3158"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}