No Surprises Act
View Your Rights and Protections Against Surprise Medical Bills
Patient Notification of RightsWhat is the No Surprise Act?
Aimed at protecting consumers from surprise billing, this portion is part of the larger Consolidated Appropriations Act of 2021. The NSA includes cost-sharing rules and prohibits balance billing for certain services involving out-of-network or emergency care. These new provisions require that self-pay patients receive an estimate shortly before their scheduled service.What does the term "Surprise Billing" mean?
A surprise bill can happen when a person unknowingly receives medical care for an out-of-network provider, facility, or air ambulance service outside of their health plans network.How do I get an estimate?
When requested, self-pay patients will be sent an estimate within 1-3 days of scheduling their appointment. If you are an individual who prefers to not have charges filed with their insurance carrier, please indicate this at the time of scheduling.What if my final charges are more than the received estimation?
Ellsworth County Medical Center is committed to providing our patients with a good faith estimate in advance to our uninsured and self-pay individuals, as well as any patient who requests an estimate.It's important to remember that your expected charges are only estimates and there are many factors that can affect your out-of-pocket costs such as co-payments, deductibles, and coinsurance.
If an uninsured (or self-pay) individual receives a bill that is substantially in excess of their good faith estimate (i.e., $400 or greater), and the patient is unable to resolve the matter with ECMC, the patient may initiate the Dispute Resolution Process by completing a request to Health and Human Services within 120 days of receiving their bill.
Information on how to implement the Patient-Provider Dispute Resolution Process can be found here:
www.HHS.gov/guidance
How can I ensure I'm being seen in-network?
Ellsworth County Medical Center has several Managed Care Contracts and we encourage our patients to see if their insurance plan includes ECMC and our providers as in-network:Aetna Better Health
Blue Cross Blue Shield
Coventry
HealthNet Federal Services (TriCare)
Health Partners of Kansas
Humana Medicare Advantage
KMAP (Medicaid)
Medicare
MultiPlan/PHS
Railroad Medicare
Sunflower
United Healthcare (UHC) Commercial
United Healthcare (UHC) Community Plan
United Healthcare (UHC) Medicare Advantage
VA CNN
WPPS (ProvDRs Care Network)
Still have questions?
Heidi Garrison
e: hgarrison@ewmed.com
p: (785) 472-3111 ext. 1403
