No one likes surprises, especially when it comes to a medical bill totaling hundreds or even thousands of dollars. Unsuspecting consumers have complained about it for years, and now there’s a federal law that should help.
But, as Consumer Reports explains, there are important exceptions you should be aware of.
January 1 not only ushered in a new year, it also ushered in the No Surprises Act, which solves a problem that millions of people covered by private health insurance face every year: surprise medical bills. Then last week, the three credit reporting agencies announced that paid medical debt sent to collections would no longer affect consumer ratings.
As of 2017, many Californians were already covered by state laws, but there were still several gaps that the No Surprises Act will fill.
For most people, the new law means they will no longer receive an unexpected medical bill after being treated by a doctor or visiting a medical facility they did not originally choose.
It’s true: no more surprise bills from ER doctors or other out-of-network hospital providers like anesthesiologists and radiologists when you receive care at an in-network facility.
The Kaiser Family Foundation estimates that the no-surprise law will apply to as many as 10 million surprise medical bills each year.
While this all sounds good, the law still has glaring flaws. Take urgent care facilities: Visits are only covered if the facility is licensed as an emergency service provider. But how do you know that? It is best to prepare ahead of time and call several urgent care facilities in your area to ask if they are licensed to provide emergency medical services.
And then there are lab tests at your regular doctor’s office. Make sure they use a network lab. Again, do your homework ahead of time to avoid surprises.
Because the law is new, hospitals and providers are still adjusting to the new rules, which means they could accidentally send you a medical bill.
If this invoice remained unpaid, it would eventually be sent to collections. Matt Schulz of Lending Tree said that once this happens, even if you pay the bill, it will negatively impact your credit report for years.
“There are few things in life more expensive than lousy credit,” Schulz said. “It’s really good that the credit bureaus are adjusting their credit reports and reporting this reality.”
Effective July 1, Equifax, Experian and Transunion will no longer count this paid medical debt on their credit reports. This could remove up to 70% of medical debt from people’s credit history.
“You could end up seeing a very significant increase in credit rating,” Schulz said. “That’s really good news for a lot of people.”
If you receive an unexpected bill, contact your insurance company to see what’s going on. And be prepared to call your provider, as they may have to resubmit your claim for full coverage. If that doesn’t work, you can file a federal complaint online at CMS.gov.
If you need additional help with a surprise medical bill, contact the Patient Advocate Foundationwhich can help you deal with unaffordable medical bills.