As of January 1, 2022, consumers have new billing protections when getting:
- emergency care
non-emergency care from out-of-network providers at in-network facilities, and
- air ambulance services from out-of-network providers.
In the past, if consumers had health coverage and got care from an out-of-network provider, their health plan usually wouldn't cover the entire out-of-network cost. In many cases, the out-of-network provider could bill consumers for the difference between the charges the provider billed, and the amount paid by the consumer’s health plan. This is known as balance billing. An unexpected balance bill is called a "surprise bill."
Get more information at this link
The website includes a section for consumers with information about filing a claim and dispute resolution at this link.
New Jersey has a law on surprise billing and advocates are asking for guidance on how state/federal law dovetail to protect NJ patients.