Know Your Rights

Protection Against
Surprise Medical Bills

At Langdon Prairie Health, your financial peace of mind is as important as your care. The No Surprises Act protects you from unexpected costs when you receive emergency care or are treated by an out-of-network provider at an in-network hospital or surgical center. 

What is Balance Billing
(Surprise Billing)?

When you visit a healthcare provider, you may have to pay out-of-pocket expenses like copayments, coinsurance, and deductibles. But, if you receive care from an out-of-network provider or facility, you could be charged for the difference between what your insurance pays and the full cost of the service, called "balance billing." This unexpected charge is often higher than in-network costs and may not count toward your annual out-of-pocket limit.

"Surprise billing" happens when you receive an unexpected balance bill, often because you couldn’t choose who provided your care, such as in emergencies or when treated by an
out-of-network provider at an in-network facility without your knowledge.

Your Protections

Emergency Services:

• You can’t be balance billed for emergency services, even from out-of-network providers. You’re only responsible for
in-network cost-sharing amounts (co-payments, coinsurance, deductibles).
• This protection extends to services received after you are stabilized unless you waive your protection by giving written
consent.

Services at In-Network Hospitals or Surgical Centers:

• Certain providers at in-network facilities may be out-of-network. In these cases, they can only bill you for in-network
cost-sharing amounts.
• This protection covers emergency medicine, anesthesia, pathology, radiology, laboratory work, neonatology, assistant
surgeons, hospitalists, or intensivists.
• For other services, out-of-network providers can only balance bill you with your written consent.

Your Rights:

• You are never required to waive your protections against balance billing.
• You can always choose a provider or facility within your plan’s network.

When Balance Billing Is Prohibited:

• You’re only responsible for in-network cost-sharing.
• Your health plan pays out-of-network providers and facilities directly for any extra costs.
• Emergency services are covered without prior authorization, even if provided out-of-network.
• Payments for emergency or out-of-network services count toward your in-network deductible and out-of-pocket limits.

If you believe you’ve been wrongly billed, contact 1-800-985-3059.
For more information, visit the Centers for Medicare and Medicaid Services website.

Offering high-quality, compassionate healthcare to all we serve.

Tel:  701-256-6100 
909 2nd St., Langdon, ND 58249
Pricing Transparency