No Surprises Act

What is the No Surprises Act?

Federal legislation protecting patients from surprise/balance medical bills when patients are treated at out-of-network Emergency Rooms.

What does the No Surprises Act mean for you?

With this new law, you can rest assured Tulsa ER & Hospital is NOT more expensive than other hospitals in the Tulsa area.

You will NOT pay any more than your in-network copay, coinsurance or deductible…The same amount you would pay at any other in-network hospital.

In addition, the physician-owned Tulsa ER & Hospital offers low wait times, concierge-level care, a comfortable environment, and other amenities that larger hospitals fail to provide.

What is a surprise medical bill?

“Surprise billing” is an unexpected balance bill from out-of-network providers. This can happen when you can’t control who is involved in your care—like when you have an emergency.

What is balance billing?

Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called “balance billing.”

Why is this important?

Surprise medical bills and balance billing pose financial burdens on consumers when health plans deny out-of-network claims or apply higher out-of-network cost sharing. Cost sharing includes your copayment, coinsurance and deductible.

How does the No Surprises Act protect you?

  1. Protects you from surprise medical billing and balance billing by out-of-network emergency providers.
  2. Makes your cost the same for Emergency Room care no matter where it was received
  3. Your health plan generally must:
    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
    • Cover emergency services by out-of-network ER’s/Hospitals/physicians.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility.
    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit

For more information on the No Surprises Act visit https://www.oid.ok.gov/nsa/