In an effort to protect patients, the federal government issued the Federal No Surprises Act (NSA). The NSA addresses several different points. The most notable point is the NSA serves to prohibit surprise billing. A surprise medical bill is an unexpected bill, often for services received from a healthcare provider or facility, that a patient may not have known was out-of-network with their insurance until a bill is received. Simply stated, an out-of-network provider cannot send a bill to a patient for any amount outside of their yearly in-network deductible and co-insurance. This does not apply to amounts paid directly to patients by their insurance provider for services rendered rather than paid to the provider. In those cases, a patient may receive a bill for full charges until the insurance payment amount is provided or paid over to the appropriate facility by the patient.

The Federal No Surprises Act was issued after lawmakers passed a law to base emergency services payments on local median in-network rates, also known as QPAs, instead of usual and customary rates. The law enacted a system where insurers and providers negotiate the correct amount to be paid. Once in agreement, the bill can be settled through an independent dispute resolution process. Insurers must now disclose how they come to the QPA-median in-network price and if they down-coded the claim for any reason

The hospital is out-of-network for all benefit plans. Hospital Notice Required by HB 2041

  • The facility is licensed as a Hospital under the provisions of Chapter 241, Health and Safety Code, and the Hospital Licensing Rules.
  • The facility charges rates comparable to other hospitals and may charge a facility fee for emergency room services.
  • The facility or physician providing services at the facility may be out-of-network with the patient’s health plan.
  • A physician(s) providing medical care at the facility may bill separately from the facility for the medical care provided to a patient.
  • The hospital is out-of-network for all benefit plans.

El hospital esta fuera de la red para todos los planes de beneficios. Aviso hospitalario requerido por HB 2041

  • La instalacion tiene licencia como Hospital bajo las disposiciones del Capitulo 241, el Codigo de Salud y Seguridad, y las Reglas de Licencias Hospitalarias,
  • La instalacion cobra tarifas comparables a otros hospitales y puede cobrar una tarifa de instalacion por los servicios de sala de emergencias.
  • El centro o médico que presta servicios en el centro puede estar fuera de la red con el plan de salud del paciente.
  • Un médico que proporciona atencion médica en el centro puede
    facturar por separado del centro para la atencion médica proporcionada a un paciente.
  • El hospital esta fuera de la red para todos los planes de beneficios.