For Consumers

Surprise medical billing

Surprise billing news

What is "surprise medical billing"?

Surprise billing happens when you are treated by a medical provider at a hospital or facility that you believe is in your health plan's network. On top of your expected out-of-pocket costs, you're also charged the difference between what your insurer has agreed to pay your provider and what your provider believes the service was worth. This amount could be hundreds or thousands of dollars.

Surprise billing is also referred to as “balance billing,” however, some balance billing is not a surprise. For example, if you seek care from a provider that you know is not covered by your plan, you would not be surprised when you receive a bill for their services, on top of what your plan covers.

Proposed legislation for 2017 - ESHB 2114 (www.leg.wa.gov)

Commissioner Mike Kreidler believes consumers should not be caught in the middle of billing disputes between insurers and providers. 

His proposed legislation would protect people from getting a surprise medical bill when they seek medical services from an in-network facility, but are treated by an out-of-network provider. Any billing disputes between the health insurer and the provider would be settled through arbitration.

Share your surprise billing story

If you or someone you know has been impacted by surprise medical billing, we’d like to hear from you. Please email your story and also let us know if we can use your story to help spread awareness of this issue.

Read consumer stories about surprise billing.

Surprise billing in the media