No Surprises Act Quiz

Published: Mar 17, 2022

The No Surprises Act is a new federal law that establishes protections from unexpected bills for consumers with private health insurance.

Test your understanding of the law and share your results!

Step 1 of 12

The No Surprises Act protects you by limiting what you have to pay for certain types of medical bills. Of the types of bills listed below, which one is not subject to No Surprises Act Protections?(Required)

A bill for emergency care from a doctor or hospital who is not in your health plan network

A bill for care you received while in an in-network hospital from a doctor who is not in your health plan network

A bill for care you received at an in-network ambulatory surgery center from a doctor who is not in your health plan network

A bill from a lab that does not participate in your health plan network, for tests ordered by your in-network primary care doctor as part of your annual check-up office visit

Don’t know/not sure

Under federal law, the most privately insured patients can be asked to pay for an out-of-network surprise medical bill is(Required)

Nothing

$400

$1,000

The amount of cost sharing that you would owe for that service if it had been provided in-network

Don’t know/not sure

The No Surprises Act prohibits “balance billing” for surprise medical bills. Balance billing by an out-of-network doctor or hospital means(Required)

Billing you for the deductible amount you owe

Billing you for the difference between the full, undiscounted charge and the amount your health plan allows

Billing you for a second time because you have a balance due

Billing you in a way that is fair and balanced

Don’t know/not sure

True or false, under federal law, consumers are now protected from balance billing for out-of-network emergency services, including ground and air ambulance transport.(Required)

True

False

Don’t know/not sure

Regulations implementing the No Surprises Act permit health plans to deny coverage for emergency services in which of the following special circumstances:(Required)

The patient did not get prior authorization for the emergency services

The patient waited more than 24 hours after symptoms onset before going to the emergency room

The patient presented at the emergency room with symptoms (such as chest pain) he feared were life-threatening, but ultimately turned out not to be (e.g., just heartburn)

None of the above

Don’t know/not sure

Consider this scenario: You had cancer surgery at an in-network hospital. Tumor tissue was sent to a laboratory outside of the hospital for analysis. The pathologist who examined the tissue does not participate in your health plan network and bills independently from both the laboratory and the hospital. Do federal surprise medical bill protections apply to the pathologist’s fee?(Required)

Yes

Don’t know/not sure

Consider this scenario: You have surgery at a hospital that participates in your health plan network, but the anesthesiologist is not in your network. Under the No Surprises Act, what is the anesthesiologist permitted to do?(Required)

Bill you directly for the care provided. Once you have submitted the out-of-network claim to your health plan, the plan should reimburse you up to the amount that would be allowed for in-network anesthesia care

Bill you directly for the care provided, but for no more than the total amount your plan would allow for in-network anesthesia care

Bill your health plan directly for the anesthesia care, and then send you a bill for no more than the amount of cost-sharing you would owe for in-network anesthesia care

Bill you for the in-network cost sharing amount for anesthesia care plus an administrative fee for dealing with your plan

Don’t know/not sure

If you get a bill directly from an out-of-network provider for emergency care, how can you tell if that bill is appropriate under the No Surprises Act?(Required)

The out-of-network provider includes a notice with the bill explaining your rights under the federal No Surprises Act, as federal regulations require

The bill indicates a discount is available if you pay it promptly

Your health plan sends you an Explanation of Benefits statement indicating the amount of in-network cost sharing you owe for the out-of-network emergency care. The out-of-network provider’s bill should match that in-network cost sharing amount

Don’t know/not sure

Which answer best describes responsibilities that apply to private health plans under the No Surprises Act?(Required)

Plans generally must cover out-of-network surprise medical bills

Plans must apply in-network cost sharing for out-of-network surprise bills

Plans must provide enrollees with an explanation of benefits (EOB) statement indicating the in-network cost sharing amount applicable to the surprise medical bill

Plans must include on each EOB for a surprise medical bill information summarizing consumer protections and contact information for appropriate government agencies in case the consumer needs more help

Plans must tell the out-of-network provider the amount of in-network cost sharing that applies to the surprise medical bill.

All of the above

Don’t know/not sure

True or false: If a health plan refuses to cover an out-of-network service provided at in an in-network hospital, consumers have the right to appeal, and State Consumer Assistance Programs can help people file appeals.(Required)

True

False

Don’t know/not sure

Under the No Surprises Act, certain out-of-network providers can ask patients in advance to waive their surprise medical bill protections, but the law specifies that certain types of providers are never allowed to ask patients for consent to waive their federal surprise billing rights. Which of the providers below are permitted to ask patients in advance to waive their federal protections?(Required)

Emergency physicians

Anesthesiologists

Surgeons

Assistant surgeons

Don’t know/not sure

The No Surprises Act establishes a new independent dispute resolution (IDR) process to determine the amount paid for surprise medical bills when out-of-network providers or facilities and health plans cannot reach agreement on their own. What do patients have to do as part of this IDR process?(Required)

Patients must submit their out-of-network surprise bills to the IDR to learn how much of the bill they must pay

Patients must appear before the IDR to attest to the out-of-network services they received

While patient cost-sharing is based on the amount that would be paid to in-network providers, patients have to pay an additional cost sharing amount if the IDR determines that the provider should be paid more than an in-network provider would have been paid.

Nothing

Don’t know/not sure

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