When you get emergency care or treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. 你 may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes 供应商 and facilities that haven’t signed a contract with your health plan. 网外供应商可能 be permitted to bill you for the difference between what your plan agreed to pay and the full 量 charged for a service. 这叫做 “平衡账单”. This 量 is likely more than in-network costs for the same service and might 不 count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. 这可以 happen when you 不能 control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
紧急服务
If you have an emergency medical condition and get emergency 服务 from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing 量 (such 作为共同支付和共同保险). 你 不能 be balance billed for these emergency 服务. 这包括服务 you may get after you’re in stable condition, unless you give written consent and give up your protections 不 to be balanced billed for these post-stabilization服务.
Refer to La RS 22:1880 (C) for details about the balance billing disclosure.
Certain 服务 at an in-network hospital or ambulatory surgical center
When you get 服务 from an in-network hospital or ambulatory surgical center, certain 供应商 there may be out-of-network. 在这些情况下, the most 供应商 may bill you is your plan’s in-network cost-sharing 量. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist 服务. 这些提供者 不能 平衡你和我的账单 不 ask you to give up your protections 不 to be balance billed.
If you get other 服务 at these in-network facilities, out-of-network 供应商 不能 balance bill you, unless you give written consent and give up your protections.
你 从来在线体育投注 required to give up your protections from balance billing. 你也不是 需要在网络外就医. 您可以选择供应商或设施 在你的计划网络中.
Refer to La RS 22:1880 (C) for details about the balance billing disclosure.
If you believe you’ve been wrongfully billed, you may contact the Louisiana Department of Insurance at (800) 259-5300. 访问 www.cms.政府 / nosurprises for more information about your rights under federal law. 访问 www.ldi.la.政府 for more information about your rights under state law.