Your Rights and Protections Against Surprise Medical Bills
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of- pocket limit.
It is your responsibility to be aware of which providers or facilities are in your insurance network. If you’re unsure if Woodlawn Hospital, or one of its providers, is in your carrier’s network, we recommend you call your insurance or access your carrier’s website to make this determination.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care; like when you have an emergency or for scheduled visits at an in-network facility but are unexpectedly treated by an out-of-network provider. Examples of such providers are: Cardiologist, Pathologist, Radiologist, Anesthesiologist/CNA, Neurologist, Oncologist or Air Transport. Details relating to a new law, effective January 1, 2022, called The No Surprise Act, are posted below for your review for those with or without insurance.