Surprise billing definition

Surprise billing means any bill received by an enrollee or insured for
Surprise billing is an unexpected balance bill. This can happen when you can’t control who is involvedin 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. Surprise medical bills could cost thousands of dollars depending on the procedure or service. Providers and facilities are not balance billing you when they seek to collect cost sharing or another amount that you agreed to pay or are required to pay under your plan for the services that they provided. You’re protected from balance billing for:
Surprise billing means the practice by a health care

Examples of Surprise billing in a sentence

  • Surprise billing occurs both for emergency and non-emergency care.

  • Surprise billing occurs when an individual receives an unexpected bill after obtaining items or services from an out-of-network (OON)2 provider, facility, or provider of air ambulance services where the individual did not have the opportunity to select a facility, provider, or provider of air ambulance services covered by their health insurance network (in- network), such as during a medical emergency.

  • This is what is known as “balance billing.” Surprise billing frequently occurs where an individual chooses an in-network provider or facility and unknowingly has an out-of-network provider involved in their care; thus, the patient is stuck with additional (above contract) costs related to the out-of-network provider’s involvement in their care.

  • Surprise billing proposals could apply protections only to covered services or could be applicable more broadly (e.g., to all specified services, without reference to whether the plan covers such services).To date, many federal surprise billing proposals have addressed other consumer costs by requiring insurers to cover a portion of such costs.

  • Capacity-building with beneficiaries, counterparts, partners and WFP staff is designed to increase awareness, develop understanding and strengthen staff skills.

  • Surprise billing occurs when an individual receives an unexpected bill after obtaining items or services from an out-of-network (OON)2 provider, facility, or provider of air ambulance services where the individual did not have the opportunity to select a provider, facility, or provider of air ambulance services covered by their health insurance network (in- network), such as during a medical emergency.

  • Surprise billing occurs when an individual receives an unexpected medical bill after obtaining items or services from an out-of-network (OON) provider, facility, or provider of air ambulance services where the individual did not have the opportunity to select a provider, facility, or provider of air ambulance services covered by their health insurance network (in- network), such as during a medical emergency.

  • Section 890.114 is added to subpart A to read as follows:§ 890.114 Surprise billing.

  • Surprise billing laws vary substantially in specified price levels and in rates arbitrators must take into account during the IDR process (Table 9.1).Table 9.1. Surprise Billing Payment Method Examples Source Payment Method SOURCES: AHA, 2021; Corlette and Hoppe, 2019; Keith, 2021; and Kona, 2021.

  • If it does not qualify for commercial rice, it must be treated as production not to count.


More Definitions of Surprise billing

Surprise billing means balance billing from an out-of-network provider in a situation where you could not 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.

Related to Surprise billing

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  • Rechargeable Electrical Energy Storage System (REESS) means the rechargeable energy storage system that provides electric energy for electrical propulsion.

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  • Energy Use Intensity (EUI means the kBTUs (1,000 British Thermal Units) used per square foot of gross floor area.

  • Sailboat means the same as that term is defined in Section 73-18-2.

  • Meet-Point Billing (MPB) refers to the billing associated with interconnection of facilities between two or more LECs for the routing of traffic to and from an IXC with which one of the LECs does not have a direct connection. In a multi-bill environment, each Party bills the appropriate tariffed rate for its portion of a jointly provided Switched Exchange Access Service.

  • MDF means a Qwest distribution frame (e.g., COSMIC™ frame) used to connect Qwest cable pairs and line and trunk equipment terminals on a Qwest switching system. "Maintenance and Repair" involves the exchange of information between Carriers where one initiates a request for maintenance or repair of existing products and services or Unbundled Network Elements or combinations thereof from the other with attendant acknowledgments and status reports in order to ensure proper operation and functionality of facilities. "Maintenance of Service charge" is a Miscellaneous Charge that relates to trouble isolation work performed by Qwest. Basic Maintenance of Service charges apply when the Qwest technician performs work during standard business hours. Overtime Maintenance of Service charges apply when the Qwest technician performs work on a business day, but outside standard business hours, or on a Saturday. Premium Maintenance of Service charges apply when the Qwest technician performs work on either a Sunday or Qwest recognized holiday.

  • NOC means Network and Support Operating Centre.

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  • Pilot or "Payment in Lieu of Tax" shall mean any payment made to the Agency or an affected tax jurisdiction equal to all or a portion of the real property taxes or other taxes which would have been levied by or on behalf of an affected tax jurisdiction with respect to a project but for tax exemption obtained by reason of the involvement of the Agency in such project, but such term shall not include Agency fees.

  • InterLATA Traffic describes Telecommunications between a point located in a Local Access and Transport Area ("LATA") and a point located outside such area.

  • HUB means Historically Underutilized Business, as defined by Chapter 2161 of the Texas Government Code.

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  • Carrier Access Billing System (“CABS”) is the system which is defined in a document prepared under the direction of the Billing Committee of the OBF. The CABS document is published by Telcordia in Volumes 1, 1A, 2, 3, 3A, 4 and 5 as Special Reports SR-OPT-001868, SR-OPT-0011869, SR-OPT-001871, SR-OPT- 001872, SR-OPT-001873, SR-OPT-001874, and SR-OPT-001875, respectively, and contains the recommended guidelines for the billing of access and other connectivity services. Sprint’s carrier access billing system is its Carrier Access Support System (CASS). CASS mirrors the requirements of CABS.

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