No Surprises Billing Act
Surprise medical bills can arise when insured consumers inadvertently receive care from out-of-network hospitals, physicians, or other providers they did not choose. This can pose financial burdens on consumers when health plans deny out-of-network claims or apply higher out-of-network cost sharing. Discover how Community Hospital of Staunton follows the No Surprises Billing Act and provides patients with good faith estimates of expected charges.
What Is the No Surprises Billing Act?
The No Surprises Act (NSA) introduced federal protections against surprise medical bills on January 1, 2022. The No Surprises Billing Act aims to protect consumers from unexpected medical bills by:
- Requiring private health plans to cover out-of-network claims and apply in-network cost-sharing.
- Prohibiting physicians, hospitals, and other covered providers from billing patients more than the in-network cost-sharing amount for surprise medical bills.
- Establishing a process for determining the payment amount for surprise, out-of-network medical bills, starting with negotiations between plans and providers and, if negotiations don’t succeed, an independent dispute resolution process.
Good Faith Estimates at Community Hospital of Staunton
As of January 1, 2022, Anderson Healthcare facilities and providers are required to give uninsured consumers or insured consumers who do not intend to use their health plan for coverage (self-paying individuals) an estimate of expected charges in good faith. This estimate will be given after a patient has scheduled a service or upon their request. It must include the expected charges for the main service as well as any other additional services provided as part of the same scheduled experience.
Community Hospital of Staunton will:
- Provide a good faith estimate within specific timeframes.
- Offer an itemized list of each service or item, grouped by the provider or facility offering care.
- Explain the good faith estimate to the patient over the phone or in person if requested and follow up with a paper or electronic estimate.
- Provide the good faith estimate in a way that is easily accessible to our patients.