Balance Billing (Surprise Medical Bills)

The Affordable Care Act has provided Mississippians with more access to not only health care, but also private health insurance. However, there are still consumer issues that present challenges for newly insured beneficiaries. One of the most prominent is balance billing. Balance billing, most commonly referred to as surprise medical bills, is the difference between what the provider charges and what the insurer will reimburse. The consumer is responsible for this amount, which can many times be in the thousands. Usually this occurs when a consumer inadvertently sees a provider out of their network in an emergency situation, which can include laboratory services or anesthesia services. In very rural areas, with limited provider networks, this issue is even more pronounced because consumers may have to go out of network to receive the services they need.