No Surprise

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Health

We talked about this last week at the New York Health and Longevity meeting and I thought it was worthwhile to share the information in today’s blog.
On January 1st, the federal No Surprise Act went into effect. Basically, it is designed to protect patients from “surprise medical bills”. New York has had a similar law in place for several years.
The usual scenario was that you would go to the hospital for a procedure (perhaps an emergency) and some time later you receive a bill from a provider (doctor) who provided services to you at the hospital and does not accept your insurance. The hospital visit was covered but not this provider. Surprise!
The new laws change this. Unless you consent, no surprises. You are responsible as if the out-of-network provider was in your insurance plan and covered by your insurance.
Details of the law are abundant on line. Be mindful and discuss this with your physician if you are planning a procedure.
Something everyone should be aware of.

Comments

Fred Klein

What about surprise ambulance exorbitant charges?

Submitted by Greg on Wed, 02/16/2022 - 22:38

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Gregory Rose

One of the most frustrating things is when bills come weeks or months later, after the appointment or an unfortunate hospital visit. You should be able to get an estimate (at least) on what you will owe while you're seeing the doctor, that way it's not as big of a surprise.
Robert Intelisano

This is a slippery slope. It is most important for people to understand how to read their "EOB" explanation of benefits statements. Im available to Gotham members to assist/deciphet. Transparency has always been an issue. We should be able to shop surgery costs like mufflers onine!
Daniel Schwartz

A good law but likely loop hopes to watch out for. I know every time I go for a procedure or to a new doctor, there are a number of pages I have to sign or fill out. Some are quite wordy and you feel pressured to sign everything to get in. I bet in the fine print, you give up some rights under this law.
Shelley Simpson

They are way less in NYC now than they were in FL when we needed them and none was covered by insurance.
Shelley Simpson

It happened to us several years ago at Mr. Sinai. Many letters, phone calls, and arguments later, we prevailed but it was because I am tenacious and know my way around the system. I am certain most people would have given up and paid and we are talking about thousands of dollars. I also think there should be a time frame during which bills must be sent. But one step at a time.
Cynthia Somma

Love this, it really puts the onus on the provider and the carrier---where it should be.

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