Surprise medical bill: what to do

Have this ready

• the bill
• explanation of benefits (EOB)
• insurance card

Steps for any company

1. Compare the bill with the explanation of benefits from the insurer.

2. If the No Surprises Act applies, tell the provider and insurer, and contact the CMS No Surprises Help Desk.

A company playbook below replaces these generic steps with the company’s own forms, phone numbers and deadlines.

Company playbooks (10)

• AetnaCheck the bill against the EOB, tell Aetna and the provider, then contact the CMS help desk.
• Anthem (Elevance Health)Check whether the No Surprises Act applies, then tell Anthem and the provider, and contact the CMS help desk.
• Blue Cross Blue Shield (BCBS Association and FEP Blue)Compare the bill with the EOB, tell the local Blue plan and the provider, then contact the CMS help desk.
• Centene (Ambetter, Wellcare, Health Net)Compare the bill with the EOB, tell the plan and the provider, then contact the CMS help desk.
• Cigna HealthcareCheck the bill against the EOB, tell Cigna and the provider, then contact the CMS help desk.
• HumanaCheck the bill against the EOB, tell Humana and the provider, then contact the CMS help desk.
• Kaiser PermanenteFor out-of-network emergency care, submit the claim to Kaiser Permanente, compare the bill with the EOB, then contact the CMS help desk.
• Molina HealthcareCompare the bill with the EOB, tell Molina and the provider, then contact the CMS help desk.
• Oscar HealthContact Oscar right away, compare the bill with the EOB, then contact the CMS help desk.
• UnitedHealthcareCompare the bill with the EOB, tell UnitedHealthcare and the provider, then contact the CMS help desk.

Guides

• Health insurance — how complaints work