Your Rights and Protections Against Surprise Medical Bills at UMass Memorial Health

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from 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, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that...

Surprise Billing and Balance Billing Protections at UMass Memorial Health

At UMass Memorial Health, we understand that healthcare billing can be confusing, and we are here to help. 

What do the terms Balance Billing and Surprise Billing mean?

Surprise Billing occurs when a patient receives a larger-than-expected medical bill due to their care provider being out-of-network. It typically occurs in the following scenarios:

  • Emergency care situations, when patients may not be able to choose health care providers covered by their insurance.
  • An out-of-network provider renders service to a patient at an in-network hospital.

Balance Billing happens when an out-of-network provider...

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