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Payment

No Surprises Act-Disclosure

 

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

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

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

(OMB Control Number: 0938-1401)

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.

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.

Further reading:

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).

Disclosure notice regarding patient protections against surprise billing

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