Surprise medical bill? Know your No Surprises Act rights
A surprise bill arrives when an out-of-network provider you didn’t choose bills you directly. Since 2022, the federal No Surprises Act has banned many of these bills outright. Here’s how to tell if you’re protected — and how to fight back.
What the No Surprises Act protects
The No Surprises Act (effective January 1, 2022) bans balance billing in three big situations:
- Most emergency services — even out-of-network and without prior authorization.
- Out-of-network providers at in-network facilities — like anesthesiology, radiology, pathology, or assistant surgeons you didn’t pick.
- Out-of-network air ambulance services.
For these, you can’t be charged more than your plan’s in-network cost-sharing, and the provider generally can’t bill you for the balance.
Ground ambulance bills are generally not covered by the federal law. Some states add their own protections — check your state’s rules.
How to dispute a surprise bill
- Confirm it’s protected — emergency, in-network facility, or air ambulance.
- Compare the bill to your EOB to see what was charged versus allowed.
- Contact the provider and insurer in writing; state that the No Surprises Act applies and request a corrected bill at in-network cost-sharing.
- File a complaint with the federal No Surprises Help Desk if the bill isn’t corrected.
- Watch for billing errors too — see medical bill errors.
If there’s also a denial
Sometimes the bill follows a claim denial — for example an out-of-network or ER denial. In that case, appeal the denial as well. Our step-by-step guide walks you through it, and IntelClaim can draft the appeal for free.
Frequently asked questions
What is a surprise medical bill?
It’s an unexpected bill from an out-of-network provider you didn’t choose — often after emergency care, or from an out-of-network clinician at an in-network facility. The No Surprises Act protects you from many of these.
What does the No Surprises Act protect?
It bans balance billing for most emergency services, for many out-of-network providers at in-network facilities, and for out-of-network air ambulance services. For these, you can’t be charged more than in-network cost-sharing.
What if I get a balance bill anyway?
You can dispute it. Tell the provider and your insurer the No Surprises Act applies, ask for a corrected bill at in-network cost-sharing, and you can file a complaint with the federal No Surprises Help Desk.
Does the law cover ground ambulances?
Generally no — ground ambulance bills are a known gap in the No Surprises Act, though some states add protections. Check your state’s rules.
Disputing a denial behind the bill? Appeal it free
IntelClaim helps you build a clear, evidence-backed appeal — free, purpose-built, and self-help.
IntelClaim is a self-help tool — not legal, medical, or insurance advice — and does not guarantee any particular outcome. Information on this site is general and may not reflect the rules of your specific plan or state. Always read your own denial letter, plan documents, and the deadlines that apply to you, and consider professional advice for your situation. No PHI is collected on this marketing site.