Blue Cross Blue Shield (BCBS Association and FEP Blue): surprise medical bill

Collect

• the bill
• EOB
• member ID card

Steps

1. Compare the bill with the EOB. Note whether it was emergency care or care at an in-network facility.

2. Tell your local Blue plan (number on the ID card) and the provider that the bill may be a surprise bill.

   PhoneFEP Blue (Federal Employee Program) National Information Center +1-800-411-2583

3. Contact the CMS No Surprises Help Desk.

   RegulatorCMS No Surprises Help Desk +1-800-985-3059

Rules in force

• No Surprises Act (surprise billing protections and good faith estimates)
  45 CFR part 149 (including 149.420 and 149.610)

  Protects patients from out-of-network surprise bills for emergency care, for non-emergency care by out-of-network providers at in-network hospitals and surgery centers, and for air ambulance services. People who are uninsured or not using insurance get a good faith estimate and can dispute a bill that is at least $400 over the estimate.

  Source: cms.gov, verified 2026-10-12

  8 citable points

  • Limit

    For emergency services, "you can't be charged any more for emergency medical services than the in-network 'cost-sharing' rate". This covers the hospital, the providers who treat you there, and air ambulance providers.

    Source: cms.gov, verified 2026-10-12

  • Policy

    The protections cover non-emergency care related to a visit to an in-network hospital, hospital outpatient department or ambulatory surgical center, and air ambulance services. Ground ambulance services generally are not covered by the No Surprises Act billing protections.

    Source: cms.gov, verified 2026-10-12

  • Policy

    A patient gives up the protections for non-emergency care only by signing a notice-and-consent form. Providers of ancillary services cannot use that form: emergency medicine, anesthesiology, pathology, radiology and neonatology; assistant surgeons, hospitalists and intensivists; diagnostic services including radiology and laboratory; and any out-of-network provider when no in-network provider is available at the facility.

    Source: law.cornell.edu, verified 2026-10-12

  • Deadline

    A notice-and-consent form for services scheduled at least 72 hours in advance must be given not later than 72 hours before the services. For services scheduled within 72 hours, it must be given on the day of scheduling, and no later than 3 hours before the services if given on the same day.

    Source: law.cornell.edu, verified 2026-10-12

  • Deadline

    Uninsured or self-pay patients must get a written good faith estimate: not later than 1 business day after scheduling when care is scheduled at least 3 business days ahead; not later than 3 business days after scheduling when scheduled at least 10 business days ahead; and not later than 3 business days after a request.

    Source: law.cornell.edu, verified 2026-10-12

  • Deadline

    Patient-provider dispute resolution is available when the provider charged "$400 or more" than its good faith estimate, for care on or after January 1, 2022, with an initial bill dated within the last 120 calendar days. The patient pays a "$25 non-refundable administrative fee".

    Source: cms.gov, verified 2026-10-12

  • Policy

    While a patient-provider dispute is in progress, the provider or facility may not move the bill to collections or threaten to, and must stop pursuing payment of a bill already in collections until the dispute is resolved.

    Source: cms.gov, verified 2026-10-12

  • Contact

    No Surprises Help Desk: 1-800-985-3059, weekdays 8:00 am to 8:00 pm ET and weekends 10:00 am to 6:00 pm ET. Complaints can also be filed online through CMS.

    Source: cms.gov, verified 2026-10-12

If that fails, escalate

Go up one step at a time. Keep the reference numbers and dates from each contact.

1. Customer service

   MailOPM review of a disputed FEHB claim (after the Local Plan reconsideration) United States Office of Personnel Management, Health Care and Insurance, Federal Employee Insurance Operations, Health Insurance 1, Room 3425, 1900 E Street, N.W., Washington, DC 20415-3610
   PhoneFEP Blue overseas customer service (FEHB), from the U.S., Puerto Rico and U.S. Virgin Islands +1-888-999-9862

   Call the number on the back of the member ID card. That is your local Blue company, an independent licensee of the Blue Cross Blue Shield Association.

2. Written complaint

   FormFEP Blue dispute a claim (disputed claims process)

   Internal appeal with the local Blue plan. FEP members: written reconsideration request to the Local Plan, then OPM.

3. Federal regulator

   MailOPM review of a disputed FEHB claim (after the Local Plan reconsideration) United States Office of Personnel Management, Health Care and Insurance, Federal Employee Insurance Operations, Health Insurance 1, Room 3425, 1900 E Street, N.W., Washington, DC 20415-3610

   FEP members only: OPM review is the external step for federal employee plans.

4. State agency

   Your state’s insurance department. Find it in the list of state agencies (also as JSON: states/<code>.json, for example states/ny.json).

   External review for fully insured non-federal plans; complaint to the state.

5. Federal regulator

   RegulatorU.S. Department of Labor, Employee Benefits Security Administration +1-866-444-3272

   Employer self-funded (ERISA) plans administered by a Blue plan.

6. Federal regulator

   RegulatorCMS No Surprises Help Desk +1-800-985-3059

   Surprise bills under the No Surprises Act.

Watch out

Related

• Surprise medical bill at other companies
• Health insurance — how complaints work
• Blue Cross Blue Shield (BCBS Association and FEP Blue): insurance claim denied
• Blue Cross Blue Shield (BCBS Association and FEP Blue): billing error