Dispute Surprise Out-of-Network Radiology Fees
No Surprises Act (42 U.S.C. § 300gg-111(b))
Patients having an X-ray, MRI, or CT scan at an in-network facility frequently receive a surprise bill months later from an independent radiology group that read the scan. Under the No Surprises Act, radiologists at in-network facilities are strictly barred from balance billing patients.
Estimated Savings
$300 – $2,500
Step-by-Step Checklist
Confirm the Imaging Facility Was In-Network
Verify that the hospital or clinic where your scan occurred participates with your insurance plan.
Issue a No Surprises Ancillary Service Demand
Inform the radiology practice that ancillary services rendered at in-network facilities are covered under 42 U.S.C. § 300gg-111.
Legal Grounds
- No Surprises Act explicitly defines radiology and pathology as non-waivable ancillary services barred from balance billing
- Patient responsibility is restricted by law to in-network deductible and copay rates
Sample Letter Excerpt
Under 42 U.S.C. § 300gg-111(b), radiology services performed at an in-network facility are non-waivable ancillary services. I cannot be balance-billed for out-of-network professional interpretation fees. Adjust this balance to in-network rates immediately.
Frequently Asked Questions
- Can an out-of-network radiologist ask me to sign a waiver?
- No. Federal regulations explicitly prohibit out-of-network radiologists and anesthesiologists from asking patients to sign balance billing waivers.
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