What is the No Surprises Act in Arkansas?

Those who suffer personal injuries can encounter unforeseen and high healthcare expenses, particularly during emergency situations. These unexpected costs can add a significant burden to individuals already grappling with the consequences of their injuries.

In Arkansas, the No Surprises Act is a law that prevents people from getting surprise medical bills when they receive out-of-network healthcare services. This legislation is all about making sure individuals in the state do not face expensive, unexpected medical costs. It sets clear rules to protect people in Arkansas from surprise bills, whether they are dealing with emergency situations or routine medical care.

If you were hurt because of someone else’s negligent behavior, seek support from our Arkansas personal injury attorneys by calling (479) 316-0438 to assess your potential case for free.

The No Surprises Act in Arkansas

As previously mentioned, the No Surprises Act is a piece of legislation designed to protect individuals from unexpected and potentially exorbitant medical bills that often result from out-of-network healthcare services. This law prohibits healthcare providers from charging patients more than the in-network cost-sharing amounts for emergency services or certain non-emergency services received at in-network facilities. In turn, it ensures that patients are not caught off guard by unforeseen expenses when seeking medical care.

Still, even with protections from the No Surprises Act, there is a wide range of damages that may result from personal injuries. Support from our Fayetteville personal injury attorneys can be very helpful to victims when reviewing their cases and determining the optimal routes to compensation.

Overview of Protections Provided by the No Surprises Act in Arkansas

The No Surprises Act can help personal injury claimants in multiple ways. For instance, the following is on overview of the protections provided by the act:

Emergency Services Protection

When it comes to emergency services, individuals are safeguarded against surprise bills for covered out-of-network services, which include air ambulance services. Notably, the Act mandates that facilities or providers, even if out-of-network, cannot bill more than the in-network coinsurance, copays, or deductibles for emergency services. This ensures that individuals in moments of crisis are protected from unexpected financial burdens associated with emergency medical care.

Non-Emergency Services Protection

The No Surprises Act extends its protective measures to non-emergency situations as well. If individuals receive non-emergency services from out-of-network providers at in-network facilities, the Act restricts these providers from billing more than the in-network copays, coinsurance, or deductibles for covered services. This provision alleviates concerns about escalating costs for essential healthcare services obtained at in-network facilities.

Preventing Excessive Charges

Crucially, the legislation stipulates that individuals can never be compelled to waive their protections and agree to pay more for out-of-network care at in-network facilities, especially for services related to emergency medicine, anesthesiology, pathology, radiology, or neonatology. This protection also extends to services provided by assistant surgeons, hospitalists, intensivists, and diagnostic services, including radiology and lab services.

Informed Decision-Making

While the Act provides comprehensive protections, individuals have the option to agree in advance to be treated by an out-of-network provider in certain situations, such as choosing an out-of-network surgeon with full awareness of the associated higher costs. In such cases, the provider is required to furnish advance information about the anticipated costs, enabling individuals to make informed decisions about their healthcare choices. Still, it is important to note that individuals will be expected to pay the balance bill along with out-of-network coinsurance, deductibles, and copays in these situations.

How Does the No Surprises Act Affect Injury Claims in Arkansas?

For individuals pursuing injury claims in Arkansas, the No Surprise Act has significant implications. When victims of accidents or injuries require medical attention, they may find themselves treated by out-of-network healthcare providers, especially in emergency situations. The No Surprise Act safeguards such individuals by capping the amount they can be charged for such services at the in-network rate. This is crucial for personal injury claimants, as it helps prevent the occurrence of unexpected and financially burdensome medical bills.

Moreover, the act requires healthcare providers and insurers to work together to settle billing disputes, sparing the injured party from being entangled in these negotiations. This provision ensures that individuals can focus on their recovery and legal proceedings without the added stress of grappling with excessive medical charges. In essence, the No Surprise Act becomes a valuable ally for those pursuing injury claims in Arkansas, shielding them from the financial shock that surprise medical bills can bring.

Enforcement of the No Surprises Act in Arkansas

Regulatory agencies in the state of Arkansas play a crucial role in enforcing compliance with the No Surprises Act. This enforcement includes overseeing billing practices, investigating complaints from individuals who may have faced violations, and taking appropriate actions against providers who fail to comply.

The state’s enforcement mechanisms may involve imposing penalties, sanctions, or other disciplinary actions against providers found to be in violation of the act. This proactive enforcement is designed to create a deterrent effect, encouraging healthcare providers to align with the act’s provisions.

What to Do if You Suspect that Your Insurance Bill is Not Allowed Under the No Surprises Act

If you received an unexpected bill that appears to violate the No Surprises Act, then you should seek guidance from our legal team right away. You may have the option to initiate an appeal with your insurance provider or request an external review of their decision. Additionally, you hold the right to submit a complaint either to the Arkansas Insurance Department (AID) or to the federal Department of Health and Human Services for further investigation and resolution. After reviewing your case, our legal professionals can identify the appropriate course of action.

In-Network Providers vs. Out-of-Network Providers in Arkansas

It is important for personal injury victims in Arkansas to understand the distinction between in-network and out-of-network providers. In-network providers are healthcare professionals and facilities that have established agreements with a specific insurance plan. Choosing these providers often results in lower out-of-pocket costs for individuals because the insurance plan has negotiated rates with them. On the other hand, out-of-network providers lack such agreements, potentially leading to higher costs for the individual.

Contact Our Lawyers for Help with Your Personal Injury Case in Arkansas

Get assistance from our Bentonville personal injury lawyers by calling (479) 316-0438 today.