Hi everyone. I had a child in the NICU in 2020 (unexpected early birth, went to an in-network hospital and eventually learned despite the NICU being inside the hospital next to the maternity ward, it was not part of the hospital and was considered out of network.
In 2021, my health insurance paid them the out of network rate. I received bills for the balance that is owed. In New Jersey in 2018, a law was passed, “The Out-of-network consumer protection, transparency, cost containment, and accountability act. This PTO hits balance billing if a patient receives at SNY health care facility either (1) medically necessary services on an emergency or urgent basis, or 2) “inadvertent out of network services” the facility and health care professional may not bill the patient for costs in excess of the patient’s deductible, copayment or do insurance but may bill the carrier for such costs.
Based on that law and my situation, would the healthcare provider be violating that act by attempting to bill me the balance? They note they will forward the remaining bill (a substantial amount) to a collection atencyS
submitted by /u/0rangePolarBear
[link] [comments]Hi everyone. I had a child in the NICU in 2020 (unexpected early birth, went to an in-network hospital and eventually learned despite the NICU being inside the hospital next to the maternity ward, it was not part of the hospital and was considered out of network. In 2021, my health insurance paid them the out of network rate. I received bills for the balance that is owed. In New Jersey in 2018, a law was passed, “The Out-of-network consumer protection, transparency, cost containment, and accountability act. This PTO hits balance billing if a patient receives at SNY health care facility either (1) medically necessary services on an emergency or urgent basis, or 2) “inadvertent out of network services” the facility and health care professional may not bill the patient for costs in excess of the patient’s deductible, copayment or do insurance but may bill the carrier for such costs. Based on that law and my situation, would the healthcare provider be violating that act by attempting to bill me the balance? They note they will forward the remaining bill (a substantial amount) to a collection atencyS submitted by /u/0rangePolarBear [link] [comments]Read Morer/HealthInsurance