Surprise Billing From Out-of-Network Providers.
In 2020, two bills were signed into Michigan Law to protect individuals from surprise billing from out-of-network providers. In non-emergency situations, out-of-network providers are now required to disclose the estimated costs of care at least 14 days in advance of the planned service. Your signature is required if you agree to pay the amount not covered by your health plan.
The federal government also passed similar bills in December 2020.
Documentation from the Providers must include:
A statement that your insurer may not cover all services
A "good-faith" estimate for services to be provided
A statement that you may request care from an in-network provider
An acknowledgment of understanding that the PARE provider has provided you with a disclosure form and cost estimate at least 14 days in advance of your planned service. If you sign this form, you are agreeing to be balance billed.
What are PARE providers?
Pathologists - Pathologists examine your labs to help reach a diagnosis for your health concerns.
Anesthesiologists- Anesthesiologists administer medications so you do not feel pain when undergoing surgery.
Radiologists -Radiologists diagnose and treat your injuries and diseases using medical imaging procedures such as X-rays.
Emergency room physicians - Emergency room physicians assess and attend to you when you enter the hospital’s emergency room
Note: In emergency situations, or if an out-of-network PARE provider fails to give you the required disclosures, you bear no liability and cannot be balance billed.