How to Appeal a Surprise Medical Bill
The No Surprises Act protects you from unexpected out-of-network bills for emergency care and certain non-emergency services. Learn how to use these protections.
No Surprises Act Overview
Since January 2022, the No Surprises Act protects you from surprise bills in these situations:
- Emergency services — regardless of whether the facility is in-network
- Non-emergency services at in-network facilities — from out-of-network providers you didn't choose
- Air ambulance services from out-of-network providers
What the Law Requires
- You pay only in-network cost-sharing amounts
- Out-of-network providers and insurers must resolve payment disputes through arbitration
- You must receive a good faith estimate before scheduled services
- Facilities must provide notice of any out-of-network providers
How to Dispute a Surprise Bill
- Check if the No Surprises Act applies to your situation
- Contact your insurer — tell them the bill violates the No Surprises Act
- Contact the provider — inform them you are protected from balance billing
- File a complaint with CMS at 1-800-985-3059 if the protection isn't honored
- Use the patient-provider dispute resolution process for uninsured or self-pay situations
Good Faith Estimate Rights
If you're uninsured or paying out-of-pocket, providers must give you a good faith estimate of costs. If the actual bill exceeds the estimate by $400 or more, you can dispute it.