No Surprise Billing

Understanding The No Surprises Act (NSA)

The No Surprises Act (NSA) protects people with private insurance from unexpected medical bills for out-of-network care at hospitals, outpatient surgery centers, and clinics.

Key Highlights:

• Balance billing is no longer allowed for out-of-network emergency and certain non-emergency services at in-network facilities.

• Uninsured and self-pay patients can request a Good Faith Estimate (GFE) of costs before receiving care.

• Patients who receive a surprise bill should first contact the provider’s office. If unresolved, they can call the No Surprises Help Desk (1-800-985-3059).

• Medicare and Medicaid patients are not covered by the NSA, as these programs already have protections against surprise billing.

  
  

Your Rights Under the NSA:

• No extra charges for emergency out-of-network care at covered facilities.

• No prior authorization is required for emergency services.

• Clear billing protections must be posted at hospitals and clinics.

• Debt collectors cannot force payment beyond what is allowed under the NSA.

• For issues with medical debt, contact the Consumer Financial Protection Bureau (CFPB) at 1-855-411-2372 or file a complaint online.
  
  

Good Faith Estimate (GFE)

• Patients who pay out of pocket can request a written cost estimate before care.

• Estimates must be provided 3 hours before same-day services or 3 days before scheduled procedures.

• If the final bill is $400+ over the estimate, patients can file a dispute within 120 days.
  
  

Getting Help

• Contact your provider’s office if you receive a surprise bill.

• Call the No Surprises Help Desk (1-800-985-3059) if the issue remains unresolved.

• File a complaint with the Centers for Medicare & Medicaid Services (CMS) if a provider does not follow the NSA.