Got a $9,800 balance bill from an out-of-network ER doc - what the No Surprises Act actually got me

Sharing this because i spent way too long thinking i was on the hook. Back in February i went to an in-network ER in Denver for what turned out to be a kidney stone. Triage to discharge was about 5 hours. The hospital was Anthem in-network, my labs were in-network, the CT was in-network. The ER physician who saw me for maybe 15 minutes? Out of network. Some staffing group i had never heard of.

Three weeks later i got a bill from the physician group for $11,200 with a notation that Anthem paid $1,400 and i owed the balance. Almost paid it before i remembered the No Surprises Act. So i didnt pay, sent a written dispute saying i never consented to OON care in an emergency, cited the NSA, and asked for the protected rate.

It took 4 phone calls, 2 written disputes, and about 11 weeks. Final adjusted balance was $312 (my in-network ER copay plus coinsurance up to my OON deductible). The group eventually wrote off the rest. They never apologized for trying to balance bill me illegally, just adjusted.

The thing nobody tells you is that the burden is on YOU to invoke the NSA in writing. They will keep sending bills hoping you pay. Get the dispute in writing within 30 days, send certified, and dont pay anything til they correct it.