No Surprises Act
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive services from out-of-network providers. It also establishes an independent resolution process for payment disputes between plans and providers, and provides new resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.
Effective January 1, 2022, there are new protections that prevent surprise medical bills. If you have private health insurance, these new protections ban the most common types of surprise bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, you can often get a good faith estimate of the cost of your care upfront, before your visit. If you disagree with your bill, you may be able to dispute the charges.
Know Your Rights: Learn More About the No Surprises Act
Before the No Surprises Act, if you had health insurance and received care from an out-of-network provider or an out-of-network facility, even unknowingly, your health plan may not have covered the entire out-of-network cost. This could have left you with higher costs than if you got care from an in-network provider or facility. In addition to any out-of-network cost sharing you might have owed, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid, unless banned by state law. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also called a surprise medical bill. People with Medicare and Medicaid already enjoy these protections and are not at risk for surprise billing.
A Good Faith Estimate shows the cost of items and services that are expected for your health care needs for an item or service.
- The estimate is based on information known at the time the estimate was created.
- The Good Faith estimate does not include any unknown or unexpected costs that may arise during treatment, and you could be charged more if complications or unusual circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
- If you receive a good faith estimate before your appointment, call our Patient Financial Services department at 401-427-7820.
If your services were rendered at a hospital, you will receive one bill from Rhode Island Medical Imaging for the PHYSICIAN SERVICE and a separate bill from the HOSPITAL for the use of the facility, supplies, and technical support.
*List hospital affiliates and verbiage*