JESSON||RAINS ATTORNEYS AT LAW
  • Home
  • Practice Areas
    • Wills and Trusts
    • Business Law & Litigation
    • Construction Contracts and Litigation
  • Team
    • Edward Jesson - Attorney
    • Kelly Rains Jesson - Attorney
    • Danielle Nodar - Associate Attorney
    • Sue Lambert - Office Manager
    • ​Ashley Deese ​- Paralegal
    • Shayla Martin - Legal Assistant
  • News & Blog
    • COVID-19 Resources
  • Contact
  • Testimonials
  • Free Resources
    • Business Resources
    • Estate Planning Resources
    • Probate Resources
📞 704-444-0594

Blog

Medical Providers: Don’t Be Caught By Surprise!

2/10/2022

0 Comments

 
Picture
By Associate Attorney Danielle Nodar

The No Surprise Act, a new law establishing protections for consumers against surprise medical billing, became effective on January 1, 2022. This law protects individuals covered by insurance from receiving surprise medical bills when receiving certain kinds of medical services, particularly emergency services, at an out-of-network facility or from out-of-network providers working at an in-network facility. Before this law became effective, an insured patient receiving care from an out-of-network provider or at an out-of-network facility may have been responsible for the balance of the bill not covered by their insurance, which could result in a patient being responsible for hundreds or thousands of dollars in “balance” or “surprise” bills. This applied even if a patient went to an in-network facility but unknowingly received care from an out-of-network provider, like an anesthesiologist or radiologist.

The No Surprise Act protects consumers from these surprise medical bills by banning surprise bills for most emergency services, even if they were received at an out-of-network facility, banning surprise billing for certain non-emergency services provided by out-of-network providers in an in-network facility, and requiring insurance to cover out-of-network claims and apply in-network rates. The law’s main aim is to protect insured consumers who may unknowingly receive out-of-network treatment.

The No Surprise Act also provides consumer protections to uninsured patients or those who choose to pay for their care out of pocket by requiring most providers to provide a good faith estimate of how much your care will cost before you receive treatment. Also, if there is a dispute over the amount payable, patients no longer serve as the middleman, as the Act establishes a negotiation and arbitration procedure between the insurance carrier and out-of-network provider.

The No Surprise Act does not apply if the patient gives prior written consent to waive their rights under the Act and be billed more for out-of-network providers. This waiver exception does not apply in an emergency situation. Consent must be voluntarily given, and the notice must clearly explain the rights the patient is waiving. Otherwise, a provider can refuse care if consent is denied. 

As this law is still new, there are still many aspects that have not been clarified, such as how the law is enforced and applied to different providers. For example, some medical communities have concerns with providing a good faith estimate prior to treatment as it may be difficult due to a lack of diagnosis or may serve as a deterrent to care for certain patients, such as those seeking mental health treatment. However, medical providers impacted by the law still have a duty to comply with its requirements, particularly with regard to notices of a patient’s rights under the law, waivers and consent to balance billing, and good faith estimates. If you think your practice may be impacted by this law, please feel free to contact Jesson & Rains.

0 Comments

    Subscribe to our newsletter.

    Subscribe

    Author

    Kelly Rains Jesson
    ​Edward A. Jesson

    Categories

    All
    529 Plans
    ADR
    Alternative Dispute Resolution
    Amendments
    Asset Protection
    Asset Purchase
    Assumed Business Name
    B-Corps
    Blockchain
    Business
    Business Formation
    Business Litigation
    Business Purchase
    Business Scam
    Buy/sell
    Civil Procedure
    Collections
    Community
    Construction
    Contracts
    Copyrights
    Corporations
    COVID 19
    Cryptocurrency
    Data Privacy
    DBA
    Default
    Dissolution
    Elder Law
    Employment
    Estate Planning
    Ethics
    Eviction
    Firearms
    Firearm Trusts
    FLSA
    Guardianship
    Health Care Directive
    Holding Company
    Intellectual Property
    Landlord-Tenant
    Liens
    Litigation
    Living Will
    LLC
    News
    No Surprises Act
    Operating Agreement
    Partnership
    Patents
    Power Of Attorney
    Probate
    Real Property
    Retirement
    Secretary Of State
    Small Business
    Trademarks
    Trade Secrets
    Transactional
    Trusts
    Wills

    RSS Feed

    View my profile on LinkedIn

      Contact us.

    Submit

    Archives

    March 2023
    February 2023
    January 2023
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    March 2016
    January 2016
    December 2015
    November 2015
    October 2015

Picture
Jesson & Rains, PLLC
5821 Fairview Road #218
Charlotte, NC 28209
(704) 444-0594
information@jessonrainslaw.com

By appointment only.

SERVICES

Wills & Trusts Probate
Business Law & Litigation
Construction Contracts & Litigation


Our Attorneys
Location

SUPPORT

Contact
Disclaimer
©Jesson & Rains, PLLC  ALL RIGHTS RESERVED.
  • Home
  • Practice Areas
    • Wills and Trusts
    • Business Law & Litigation
    • Construction Contracts and Litigation
  • Team
    • Edward Jesson - Attorney
    • Kelly Rains Jesson - Attorney
    • Danielle Nodar - Associate Attorney
    • Sue Lambert - Office Manager
    • ​Ashley Deese ​- Paralegal
    • Shayla Martin - Legal Assistant
  • News & Blog
    • COVID-19 Resources
  • Contact
  • Testimonials
  • Free Resources
    • Business Resources
    • Estate Planning Resources
    • Probate Resources