Bill PushbackBill Pushback / Out-of-network
A surprise out-of-network bill: where to turn
If you got emergency care, or a doctor outside your network treated you at an in-network hospital, federal rules may limit what you can be billed. Here is where to check.
General information, not legal, medical or financial advice. Ask a lawyer before acting on it.
Start with the government's own page
The Centers for Medicare & Medicaid Services (CMS) runs the No Surprises Help Desk and explains which bills these protections cover on its medical bill rights page. You can submit a complaint there or ask the help desk about your bill.
Gather this first
- The bill, and the itemized bill if you have it.
- Your insurer's explanation of benefits (EOB) for the same date.
- Whether the visit was an emergency, and the name of the hospital or facility.
- Any consent form you signed about out-of-network care.
While you wait
Ask the billing office in writing to hold the account while it is reviewed. The charge dispute letter can be used for that.
A letter asking for a review
The surprise bill letter asks the provider to check whether the No Surprises Act applies to your bill and to hold the account meanwhile.
For the phone calls
The Medical Bill Fight Kit
A 9-page PDF you print: the order of steps, word-for-word call scripts for the billing office, your insurer, financial assistance and a collection agency, five letters with blanks (the three free ones here, plus a financial assistance request and a payment agreement confirmation) and a call and mail log.
$9 Buy the kit
If the file doesn't work or isn't what this page describes, write to us within 14 days for a full refund.