No Surprises Act Disclosures
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
When you get emergency care or get treated by an out-of-network provider
at an in-network hospital or ambulatory surgical center, you are protected
from surprise billing also known as balance billing.
What is “balance billing” (sometimes called “surprise 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. You 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 providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t 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.
You are protected from balance billing for emergency services and certain services at in-network hospital or ambulatory surgical centers. Journeys does not provide emergency services nor are we an ambulatory surgical center, but we do commit to the same rights for our clients to not receive surprise bills. We encourage all our clients to connect with member services at their insurance carrier to receive information specific to their policy as it relates to deductibles, copays and any other coinsurance fees that may be earmarked as patient responsibility.
Journeys’ also commits to provide all uninsured or self-pay clients with a good faith estimate for all expected charges associated with services provided at our facility. You have the right to request a good faith estimate in writing prior to receiving any services at Journeys. If you receive a bill that is $400 more than your good faith estimate, you can dispute that bill. Make sure you save a copy of your good faith estimate. For more information about good faith estimates, visit cms.gov/nosurprises
If you believe you have been wrongly billed, please contact Consumer Protection for the State of Delaware at 800-220-5424 or email email@example.com for assistance.