您的权利和防止惊喜医疗费用

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.

什么是“余额计费”（有时称为“惊喜计费”）？

When you see a doctor or other health care provider, you may owe certainout-of-pocket costs，像一个共付，，，，共同保险，或者deductible。如果您看到提供商或访问不在健康计划网络中的医疗机构，则可能需要额外费用或必须支付整个账单。

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

在休斯顿的Uthealth和UT医师，您免受余额计费的保护：

EMERGENCY SERVICES

如果您患有紧急医疗状况并从网络外提供者或设施中获得紧急服务，那么我们最大的收费是您的计划的网络内成本分担金额（例如共付额，共同保险和免赔额）。这些紧急服务将不会达成平衡费用。这包括您处于稳定状态后可能获得的服务，除非您给予书面同意并放弃保护措施，以免对这些稳定后服务进行平衡。

CERTAIN SERVICES AT AN IN-NETWORK HOSPITAL OR AMBULATORY SURGICAL CENTER

当您从网络内医院或门诊外科中心获得服务时，一些提供商可能是网络外的。在这些情况下，这些网络外提供商最多的是您计划的网络内成本分担金额。这适用于急诊医学，麻醉，病理学，放射学，实验室，新生儿学，助理外科医生，住院医生或强化主义服务。这些提供者无法平衡您的账单，也可能不会要求您放弃保护，以免获得平衡费用。

如果您在这些网络内设施中获得其他类型的服务，则除非您给予书面同意并放弃保护措施，否则网络外提供者将无法平衡您的账单。

我们永远不会要求你给你p your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

当不允许余额计费时，您还拥有这些保护：

You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.

Generally, your health plan must:

涵盖紧急服务，而无需您提前批准服务（也称为“先验授权”）。
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
计算您为紧急服务或网络外服务支付的任何金额，以扣除网络内扣除和自付限额。

需要估算吗？

您有权获得“诚信估计”，以解释您的医疗费用将花费多少。有关更多信息，请通过电子邮件将您的请求发送给我们的客户服务办公室neuro.billingquestions@uth.tmc.edu。

要求估算临床服务

Uthealth Houston和UT医师很高兴为服务提供估计。为了提高准确性，当您要求估算时，请提供有关感兴趣的服务的程序代码（CPT）和诊断代码（ICD-10）。

您的医师或诊所可以向您提供此信息，并且对于确保您获得适当治疗或程序的估算值很重要。

请通过电子邮件将您的请求发送给neuro.billingquestions@uth.tmc.edu。*

Once the information is provided, you will receive a response in 2-3 business days.

* Please keep in mind that communications via email over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed.

为您的护理获得正式的诚意估算

如果您想对即将在Uthealth Houston和UT医师进行的预定服务进行正式的诚意估算，请发送电子邮件neuro.billingquestions@uth.tmc.eduand include Estimate Request in the subject line. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For questions or more information about your right to a Good Faith Estimate, visitwww.cms.gov/nosurprises。

需要帮助？

If you think you’ve been wrongly billed:

您可以通过1-855-877-2808与我们的UTHEADY HOSTON和UT医师服务办公室联系，或在我们的团队发送电子邮件给我们的团队neuro.billingquestions@uth.tmc.edu。

If you have a State of Texas regulated insurance plan or have coverage through the Texas employee or Teacher Retirement System, then you may have additional protections regarding surprise medical bills. For more information, please visithttps://www.tdi.texas.gov/medical-billing/index.html。

有关得克萨斯州保险公司的余额计费问题的信息或协助，请访问https://www.tdi.texas.gov/medical-billing/surprise-balance-billing.html。

Visithttp://www.cms.gov/nosurprises有关您根据联邦法律的权利的更多信息。信息和投诉的联邦电话号码为：1-800-985-3059。