Ошибки медицинского выставления счетов и ваши права в Missouri

Закон штата Missouri

Missouri health care cost estimate on request

Missouri's Health Care Cost Reduction and Transparency Act directs health care providers to furnish a written estimate of the cost of a particular service, imaging procedure, or surgery when a patient submits a written request that includes a treatment plan from the patient's provider, within three business days of the request.

Что вы можете сделать: Submit a written request to the provider that includes a treatment plan and ask for the written cost estimate; the provider must respond within three business days. This covers a prospective estimate for a specified service, not a line-by-line itemization of a bill already received.

Ссылка: Mo. Rev. Stat. § 191.875.3 · действительно 2016-10-14

Федеральное право

No Surprises Act good-faith estimate & patient-provider dispute

Uninsured and self-pay patients are entitled to a good-faith estimate of expected charges before scheduled care. If the final bill from a provider exceeds the good-faith estimate by at least $400, the patient may initiate the patient-provider dispute resolution (PPDR) process.

Что вы можете сделать: Compare the good-faith estimate to the final charges; where the bill exceeds the estimate by $400 or more, dispute the coding and charges and, if applicable, initiate the federal patient-provider dispute resolution process within 120 days of the bill.

Ссылка: No Surprises Act, PHS Act § 2799B-6; 45 C.F.R. § 149.610–.620 · действительно 2022-01-01

Федеральное право

Section 501(r) financial-assistance & charity-care policy

Tax-exempt nonprofit hospitals must maintain a written financial-assistance policy (FAP), limit amounts charged to FAP-eligible patients to no more than amounts generally billed (AGB) to insured patients, and refrain from extraordinary collection actions before making reasonable efforts to determine FAP eligibility.

Что вы можете сделать: Apply for financial assistance under the hospital's FAP within the application period (at least 240 days from the first post-discharge billing statement) and require charges be limited to amounts generally billed.

Ссылка: 26 U.S.C. § 501(r); Treas. Reg. § 1.501(r)-4, -5, -6 · действительно 2016-01-01

Федеральное право

Fair Debt Collection Practices Act — debt validation

When a debt is with a third-party collector, the consumer may dispute the debt and request validation. On a timely written dispute, the collector must cease collection until it mails verification of the debt.

Что вы можете сделать: Send a written debt-validation request disputing the debt; the collector must cease collection activity until it mails verification of the debt.

Ссылка: Fair Debt Collection Practices Act § 809, 15 U.S.C. § 1692g · действительно 1977-09-20

Где сообщить о проблеме выставления счетов в Missouri

Если больница или страховщик не исправят счет, который нарушает приведенные выше правила, вы можете сообщить об этом государственным учреждениям, которые их обеспечивают. Подача жалобы бесплатна, и эти учреждения могут заметить закономерности, даже когда они не могут разрешить один счет. Отчет не гарантирует никакого результата, и это общая информация, а не юридический совет.

Агентства Missouri

• Missouri Attorney General — Consumer Complaints
• Missouri Dept. of Commerce & Insurance — File a Complaint

Федеральная помощь

• Consumer Financial Protection Bureau (CFPB) — submit a complaint about medical bills or debt collection
• No Surprises Act help (federal CMS) — surprise bills and good-faith estimates