Payment

No Surprises Act-Disclosure

 

You are entitled to the “No Surprises Act- Disclosure”. 

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This document is shared with you electronically during your first appointment. 

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YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

(OMB Control Number: 0938-1401)

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When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

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If you believe you’ve been wrongly billed, you may contact the Maryland Consumer Protection Division’s Health Education and Advocacy Unit at 410-528-1840 or toll-free at 1-877-261-8807 for more information about your rights under Maryland state laws.

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Further reading:

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For more information about your rights under federal law and to obtain information about dispute resolution processes, visit the Center for Medicare & Medicaid Services (CMS).

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Disclosure notice regarding patient protections against surprise billing