- Derek Graham
Surprise Medical Bills: Understand Your Rights
Updated: Mar 31, 2022
By Derek Graham
There is not much worse than having a child or loved one in the hospital. Finally getting to bring the child or loved one home is such a relief. But while the patient recovers, the family often then embarks on a waiting game to see how many different bills they will receive. Sometimes it feels like there is no rhyme or reason to some of the invoicing.
I can recall receiving invoices several weeks after my daughter had been hospitalized from medical companies we had never heard of, and who supposedly (and I’m sure they did) provided testing and medical services while she was a patient. Talk about a bad surprise—unexpected medical bills are a budget killing bad surprise!
What is worse, there is no end in sight. You never know when another bill will come, and then another, and then another. Sometimes random bills for out-of-network services come weeks later and you didn’t even realize you (or in my case, my daughter) ever had the service. It is remarkably frustrating!
Earlier this year, two very important changes took place regarding medical billing in the state of Ohio. On January 1, 2022, the federal No Surprises Act (“NSA”) went into effect and on January 12, 2022, Ohio’s HB 388 went into effect.
What does this mean?
The NSA applies to emergency services and out of network nonemergency services. It limits what costs providers can shift to patients, prohibits balance billing, and requires facilities to notify patients of their rights and protections against surprise medical bills.
The Ohio statute compliments the federal rules by protecting patients from receiving and paying unexpected or surprise medical bills that exceed the in-network rate from health care providers in the context of emergency and unanticipated out-of-network care.
Of course, there are exceptions, loopholes, and gray areas, but by and large this bill is a huge step in the right direction.
There are federal and state websites geared toward providing more explanation and resources to patients and their families. Please check out the following websites for some great Q & A, as well as more details on when and how these new laws will impact you. Next time you get a “surprise” bill following medical treatment—know your rights and be an advocate!
National Resource: https://www.cms.gov/nosurprises
Ohio Resource: https://insurance.ohio.gov/strategic-initiatives/surprise-billing