No Surprises Act
Did you know that you can receive a cost estimate for your lab services?
As part of the No Surprises Act, health care providers are required to provide a Good Faith Estimate of the expected costs of services for patients not using insurance. To get your estimate for services, contact us at 855-522-2677.
Cost estimates may also be available in your Labcorp Patient™ account. You can create an account anytime to see lab orders and other important information about your lab testing.
Your Rights and Protections Against Surprise Medical Bills
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. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs such as a copayment, coinsurance, and/or a deductible. You also may have additional costs or have to pay the entire bill if you receive care from a provider that isn’t in your plan’s network.
- “Out-of-network” means the provider has not signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.
- “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
What are your protections under the No Surprises Act?
- You are protected from “balance billing” for:
- Emergency services: If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get at the facility caring for you after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
- Certain services at an in-network hospital or ambulatory surgical center: When you get services from an in-network hospital or ambulatory surgical center, certain providers that provide services in connection with your care may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
- Certain services if your plan is subject to certain state-law requirements: Certain states have their own laws relating to balance or surprise billing with additional protections that might apply to your health plan. Click on your state below to learn about to get more information.
- You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
- When balance billing isn’t allowed, you’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to Labcorp directly. Generally, your health plan must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.
What if you think you’ve been wrongly billed?
- If you have coverage regulated by your state, please click on your state below to learn more about contacting your state’s enforcement agency or the U.S. Department of Health & Human Services to file a complaint and/or for more information about your rights under state and/or federal law.
- If you have self-funded or self-insured coverage through your employer (federally-regulated under ERISA), you may file a complaint with the federal government and/or learn more about your rights under federal law at https://www.cms.gov/nosurprises/consumers or by calling 1-800-985-3059. However, if your plan was issued in Georgia, Maine, Nevada, New Jersey, Virginia, Texas, or Washington, your plan may have opted-in to state law. Click on your state to learn more.