What is surprise billing (sometimes called balance billing)?

Surprise (balance) billing typically happens when a person needs emergency care and is not able to choose an in-network provider without risking their health or life, or when a person seeks non-emergency care at an in-network hospital or facility, and some types of medical providers, including anesthesiologists, radiologists, pathologists, and labs are not contracted with your health insurer. So in addition to your expected out-of-pocket costs, you may also get a bill for the difference between what your insurer has paid the provider and the amount the provider or facility billed for their services.

Your surprise bill may be eligible for either the ARIZONA or the FEDERAL program:

 

ARIZONA Surprise Medical Bills 

If you receive a balance bill for health care services under a policy plan year that began prior to January 1, 2022, you may be eligible for the Arizona Surprise Out Of Network Billing Dispute Resolution Program.

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FEDERAL Surprise Medical Bills 

    Congress enacted the new No Surprises Act to limit surprise medical billing for out-of-network healthcare. It applies to policies that are new or renewed as of January 1, 2022.

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    Surprise Medical Bills