Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
"Healix360 provides advanced mobile wound care through licensed physicians and nurse practitioners. Care is provided in homes, assisted living communities and skilled nursing facilities in listed California service areas."
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, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn't in your health plan's network.
"Out-of-network" describes providers and facilities that haven't signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay 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 annual out-of-pocket limit.
Good Faith Estimate
Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Our Commitment to Transparency
At Healix360, we verify your insurance benefits prior to initiating care. We will inform you of your expected financial responsibility—such as applicable deductibles or Medicare Part B coinsurance—before your first clinical assessment.
Contact Information
If you believe you've been wrongly billed, you may contact the Federal No Surprises Help Desk at 1-800-985-3059 or visit www.cms.gov/nosurprises for more information about your rights under federal law.
For questions regarding a bill from Healix360 providers, please contact our billing department at 877-545-1300.
You Don't Have to Live With a Wound That Won't Heal
Get connected with an experienced wound care specialist today and take the first step toward healing. Most treatments are covered by Medicare Part B.