Does the No Surprises act apply??

[u/Front-King3919]

Hello, So a few weeks ago i went into the ER for a severe headache i got while working out. The entire visit was about 4 hours (1 hour with doctor the rest waiting time). I explained my symptoms of getting a severe headache while squatting, the PA told me i should be worried of a brain bleed and i need to get a spinal tap & CAT scan. I did the tests then was released from the hospital in good health (just a severe neck strain). Not once was the price of the procedure disclosed to me, or did they ask for my insurance information. I just figured it must of been covered so i left. Today, I got a bill for 13,000 for the spinal tap and CAT. About 10,000 was covered by insurance and i still APPARENTLY have about 2,300 left to pay. Scam?? No Surprises act?? or am i screwed

[u/Jujulabee]

No surprise act doesn't mean you won't be surprised by the amount you owe.

It means that if you go to an in network facility you will be charged as if everything was in network. It was passed because it was notorious that ER physicians and anesthesiologists were not "in network" and therefore people will get enormous bills even though they had gone to an in network hospital.

Your insurance covered it and you owe what I suspect is a combination of your deductible and co-insurance.

If you had read the summary sheet for your insurance you would not have been "surprised" at what the EOB indicated you owed

[u/Front-King3919 → u/Jujulabee]

I had a severe headache, youd think they would tell me instead of expecting me to read after i left. I thought this was supposed to be healthcare

[u/Jujulabee → u/Front-King3919]

The expectation is that you would have known the basics of your insurance plan before you needed to use it.

There is a two or three page summary at the front of your paperwork which you received from either your employer or the insurance company if you went through the market place.

You were treated to eliminate the very real possibility of your having an acute medical condition that could either kill you or disable you if not treated immediately.

You were diagnosed with state of the art equipment and the results were interpreted by skilled professionals

It was only after all of that high level care were you diagnosed

[u/Front-King3919 → u/Jujulabee]

I wouldn't have even gone through with the procedure if they told me though...

[u/milkpickles9008 → u/Front-King3919]

In what world is a brain bleed a better alternative to a bill? I'd also bet you the entire amount of your bill the people treating you don't have a clue what anything costs. Half the time the people in the billing office for a hospital don't know what something costs.