Surprise billing definition

Surprise billing means any bill received by an enrollee or insured for
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Surprise billing means the practice by a health care
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Surprise billing is an unexpected balance bill. This can happen when you cannot control who is involved in your care – such as 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.
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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.
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Related to Surprise billing

  • Balance billing means charging or collecting an amount in excess of the Medicaid, Medicare, or contracted reimbursement rate for services covered under a Medicaid, Medicare or employer sponsored beneficiary’s plan. “Balance Billing” does not include charging or collecting deductibles or copayments and coinsurance required by the beneficiary’s plan.

  • Live birth means the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy, which after such expulsion or extraction, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.

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

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

  • 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.

  • NOC means Network and Support Operating Centre.

  • HRS means the Hawaii Revised Statutes.

  • Distance education means education imparted by combination of any two or more means of communication, viz. broadcasting, telecasting, correspondence courses, seminars, contact programmes and any other such methodology;

  • 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.

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

  • Distribution center means a building or structure used primarily for the storage of goods which are intended for subsequent shipment to retail outlets. Distribution center does not mean a building or structure used primarily to store raw agricultural products, used primarily by a manufacturer to store goods to be used in the manufacturing process, used primarily for the storage of petroleum products, or used for the retail sale of goods.

  • Levee system means a flood protection system which consists of a levee, or levees, and associated structures, such as closure and drainage devices, which are constructed and operated in accordance with sound engineering practices.

  • Adult motion picture theater means a commercial establishment where, for any form of consideration, films, motion pictures, video cassettes, slides, or similar photographic reproductions are regularly shown which are characterized by the depiction or description of "specified sexual activities" or "specified anatomical areas."