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Every year, millions of Americans receive surprise medical bills after unknowingly receiving treatment from a provider outside of their insurance network. Studies have shown that nearly one in five emergency room visits and hospital stays results in a surprise out-of-network bill, which can cost between hundreds to thousands of dollars. Although Arizona passed a state law in 2017, the law does not prevent providers from sending the bill in the first place. This means consumers have to spend time and energy and follow a somewhat complicated process in order to fight an unfair bill.
To help protect consumers from surprise medical bills, the Arizona PIRG Education Fund launched a campaign today to educate consumers on their rights to push back if they receive a surprise medical bill. As part of the effort, the Arizona PIRG Education Fund developed and is distributing information on legal protections and tips for fighting surprise bills.
“Arizona consumers often struggle to understand the pile of medical bills they receive after a health crisis,” said William McGovern, Health Care Associate for the Arizona PIRG Education Fund. “In particular, out-of-network bills often come as a surprise, and at times consumers aren’t even legally obligated to pay them. Consumers need to have information to identify and fight surprise medical bills.”
The Arizona PIRG Education Fund’s tip sheet explains consumer protections under state law, which sets up a mediation process through which consumers can contest surprise bills. Consumers who are sent surprise bills that fall under the law’s criteria should be able to have their out-of-pocket costs reduced to just their copayment, coinsurance or deductible if they follow the process. Arizona PIRG Education Fund’s tip sheet helps consumers navigate this process and shows how best to get a surprise bill reduced.
“While current Arizona policy offers some consumer protections, the law does not adequately protect Arizonans from surprise medical bills,” stated McGovern. “However, under the Arizona PIRG-supported No Surprises Act, all insured Arizonans will be covered by a federal law that bans surprise medical bills and protects consumers from this unfair practice starting in January 2022.”
According to McGovern, the No Surprises Act will protect consumers by prohibiting providers from sending surprise bills, meaning Arizona residents will not have to request mediation if they get a surprise bill. The ban will apply to surprise medical bills of any amount, unlike Arizona’s current law which only applies to bills over $1,000. The federal law will also end surprise out-of-network billing by air ambulances. Unfortunately, the federal and Arizona law will still leave patients unprotected from one of the most common surprise bills: ground ambulances.
To download the tip sheet, please go to www.ArizonaPIRGEdFund.org.
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