Patient billing rights
Federal law and Texas law protect many patients from certain unexpected out-of-network charges. Uninsured and self-pay patients also have the right to ask for a written estimate of expected charges.
Out-of-network means a provider or facility has not signed a contract with your health plan. Balance billing is when an out-of-network provider bills you for the difference between its charge and what your plan pays.
Federal protections
No Surprises Act
If you have group or individual health coverage, federal law generally limits your cost to your plan's in-network cost-sharing amount in these situations.
If you receive emergency services from an out-of-network provider or facility, you generally cannot be charged more than your plan's in-network cost-sharing amount. This includes certain services after you are stable unless the law's notice and consent requirements are satisfied.
At an in-network hospital or ambulatory surgery center, out-of-network anesthesia and certain other ancillary services generally cannot be balance billed. These anesthesia protections generally cannot be waived through a notice and consent form.
Texas protections
For health plans regulated by the Texas Department of Insurance, Texas law bans balance billing for emergency care and for care at an in-network facility when the patient did not have a choice of doctors. A narrow exception may apply when a patient knowingly chooses an out-of-network provider and the required waiver rules are followed.
Your insurance card may show TDI or DOI if the plan is regulated by Texas. Federal protections may still apply when Texas law does not.
Texas surprise-bill helpFor uninsured or self-pay patients
If you do not have insurance or do not plan to use insurance to pay for an item or service, you have the right to receive a written Good Faith Estimate explaining the expected cost of your care.
Ask for an estimate before you schedule care, or at any time before the service. When care is scheduled at least 3 business days in advance, federal timing rules require the convening provider or facility to provide an estimate.
The estimate should list the expected charges for the items or services reasonably expected for your care. Save the estimate so you can compare it with your bill.
If a bill from a provider or facility is at least $400 more than that provider or facility's Good Faith Estimate, you may be able to use the federal patient-provider dispute resolution process.
Call HK Anesthesia Services and ask for a Good Faith Estimate.
Questions or concerns
Start by calling your health plan and the provider shown on the bill. If you believe you were wrongly billed, these official resources can help.
These protections depend on your health plan, where care is provided, and the services received. This page provides general information and is not legal advice. Your health plan and the government agencies above can explain which rules apply to you.