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Surprise Billing

Welcome to the Your Rights and Protections Against Surprise Medical Bills resource for patients considering or undergoing ASC (Ambulatory Surgery Center) procedures. Here are some important rights and protections that you should be aware of:

  1. Advance Notice of Provider Network: Your insurance company must provide you with a list of in-network providers before you receive care, including providers that may be involved in your care at the ASC.
  2. In-Network Coverage: Your insurance company must cover the cost of services provided by in-network providers, including services provided by the ASC, at the contracted in-network rates.
  3. Emergency Services: If you receive emergency care at an out-of-network facility, your insurance company must cover the cost of care at the in-network rate.
  4. Independent Dispute Resolution (IDR): If you receive a surprise medical bill, you have the right to request an IDR process to resolve disputes between the ASC and your insurance company.
  5. Cost Estimates: The ASC is required to provide you with an estimate of the cost of your care before your procedure, including any out-of-pocket expenses that you may be responsible for.
  6. Explanation of Benefits (EOB): Your insurance company is required to provide you with an EOB that details the cost of your care, including any deductibles, copays, and coinsurance amounts.
  7. Consumer Assistance: You can contact your state’s insurance department or consumer protection agency for assistance with surprise medical bills.

It is important to be aware of your rights and protections against surprise medical bills. If you have any questions or concerns about billing for your care at the ASC, please do not hesitate to speak with the staff or billing department, or contact your insurance company for more information.