Your situation: You got a bill from an out-of-network provider

This action plan applies to you if: 

• You got an unexpected medical bill
• You used health insurance
• You went to an in-network facility

 

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Action Plan

Check your bill for errors.

Does your bill match what happened when you got care? Are you getting billed twice for the same thing or for services you didn’t get? 

Learn how to check your bill

Check your paperwork to see if you signed a notice and consent form.

You may have signed a notice and consent form before getting care.

Signing this form means that you gave consent to get care out-of-network without the protections against balance billing. Generally, this is more expensive.

Providers must follow rules to get your valid consent.

Learn about the rules of notice and consent forms

You won’t get a notice and consent form if you got care at an out-of-network facility. If this situation applies to you, talk to your provider.

Talk to your provider. If they gave you an out-of-network bill at an in-network facility and didn't get your consent, they may not be following federal regulations.

The No Surprises Act gives you billing protections in many situations. You shouldn't get a surprise bill when you get non-emergency care from an out-of-network provider related to your visit to an in-network:

• Hospital
• Hospital outpatient department
• Ambulatory surgical center

You only have to pay your in-network copay, coinsurance, and deductible, even if your provider is not in your health plan’s network.

A provider or health care facility might have violated your rights by charging you more.

(Note: These protections don't apply if you signed the notice and consent form.)

Learn about your rights under the No Surprises Act

If you think your provider isn't following the law, submit a complaint.

Submitting a complaint will help us ensure that you and other patients don't experience over charging in the future.

Learn how to submit a complaint

Ask for a lower bill.

Providers (or their billing departments) can sometimes lower your bill. They may also offer payment plans. Talk to your provider to learn about your options.

Get tips for talking to your provider

Ask for financial assistance.

Nonprofit hospitals must give financial assistance to eligible patients who cannot afford to pay. If you got care elsewhere, they may still offer financial assistance.

Ask your health care facility's billing department about financial help.

Learn how to apply for financial assistance