You can choose a provider or facility in your plan's network. You also aren't required to get out-of-network care.
You're never required to give up your protections from balance billing. If you get other types of services at these in-network facilities, out-of-network providers can't balance bill you, unless you give written consent and give up your protections. These providers can't balance bill you and may not ask you to give up your protections not to be balance billed.
This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. In these cases, the most those providers can bill you is your plan's in-network cost-sharing amount.
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In addition, California Assembly Bill 72 (AB 72) prohibits an out-of-network physician from billing you for non-emergency services you receive at an in-network hospital.Ĭertain services at an in-network hospital or ambulatory surgical center This includes services you may get after you're in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.Ĭalifornia law also prohibits balance billing for emergency services if you are a member of a health care service plan regulated under the Knox-Keene Act. You can't be balance billed for these emergency services. If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan's in-network cost-sharing amount (such as co-payments, coinsurance, and deductibles). You're protected from balance billing for: Surprise medical bills could cost thousands of dollars depending on the procedure or service. This can happen when you can't 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. "Surprise billing" is an unexpected balance bill. This is called " balance billing." This amount is likely more than in-network costs for the same service and might not count toward your plan's deductible or annual out-of-pocket limit.
EL CAMINO HOSPITAL MOUNTAIN VIEW PHONE NUMBER FULL
Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. "Out-of-network" means providers and facilities that haven't signed a contract with your health plan to provide services. You may have additional costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn't in your health plan's network. When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, like a co-payment, coinsurance, or deductible. What is "balance billing" (sometimes called "surprise billing" )? In these cases, you shouldn't be charged more than your plan's co-payments, coinsurance, and/ or deductible. When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. Your Rights and Protections Against Surprise Medical Bills The portion of your bill that's your responsibility is commonly referred to as your out-of-pocket expense, which varies from person to person and depends on individual insurance policies. If you have questions about those bills, please call the telephone numbers on their statements for assistance. Independent lab and radiology services - those not directly associated with El Camino Hospital, but which may be used by your doctor.Anesthesiologists, radiologists, pathologists, and other specialists.Doctors and other clinicians who provide services will bill you separately. The estimates provided include only charges related to your hospital bill. We obtain data from the most recent year to determine pricing on our most common procedures and inpatient stays. El Camino Hospital makes no guarantees regarding the accuracy of the pricing information posted here and shall not be held liable for any inaccuracies. As a result, the final bill may differ from the estimate provided. Since we can't anticipate all the charges associated with a course of treatment, we can't determine the exact total cost of a procedure in advance. While we make every effort to ensure the accuracy of our price estimates, the costs associated with diagnostic testing and medical care vary, depending on the medical needs and circumstances of the individual.
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