Your Rights and Protections Against Surprise Medical Bills

A Connected Soul Counseling LLC is committed to transparency regarding the cost of services. Federal and Colorado laws provide certain protections against unexpected medical bills, also known as surprise billing or balance billing.

What is balance billing?

When you receive healthcare services, you may be responsible for out-of-pocket costs such as copayments, coinsurance, and deductibles.

If you receive services from a healthcare provider who is not in your health insurance plan's network, you may sometimes be billed for the difference between what your insurance pays and the provider's full charge. This is called balance billing.

Surprise billing occurs when you unexpectedly receive services from an out-of-network provider, particularly in certain emergency situations or when receiving care at an in-network healthcare facility.

Your protections under federal law

Under the federal No Surprises Act, you are protected from certain unexpected out-of-network bills, including:

Emergency services

If you receive emergency services from an out-of-network provider or facility, your insurance generally must cover those services at the in-network cost-sharing rate. You cannot be balance billed for protected emergency services, except in certain circumstances permitted by law.

Certain services at in-network facilities

If you receive services at an in-network hospital or ambulatory surgical center, certain out-of-network providers generally cannot bill you more than your in-network cost-sharing amount. These protections apply to specific services and circumstances established under federal law.

You are not required to waive your federal surprise billing protections.

Colorado protections

Colorado also has laws protecting consumers from certain surprise medical bills. These protections generally apply to covered emergency services and certain situations involving out-of-network providers at in-network healthcare facilities.

The applicability of Colorado protections depends on your insurance plan and the type and location of services received. Not all insurance plans or healthcare services are covered under Colorado's state protections.

Questions or concerns about billing?

If you believe you have received an improper surprise or balance bill, you may contact:

Colorado Division of Insurance 303-894-7490 1-800-930-3745 doi.colorado.gov

Federal No Surprises Help Desk 1-800-985-3059 www.cms.gov/nosurprises

For additional information about your rights and protections, please visit the resources above.

This notice is provided for informational purposes and does not replace the terms of your health insurance plan or applicable federal and state laws.