From the Patient Perspective: Why the No Surprises Act is So Important

Erica Palmer

Senior Content Marketing Manager

The No Surprises Act has been the epicenter of discussion for a while now, especially over the last few months. While the legislation is broad and a bit confusing for those on the provider side, the benefits that both providers and patients will experience once changes are underway will be undeniable. While all healthcare providers will need to put in the initial time and resources to comply with the No Surprises Act, after doing so, you’ll experience happier patients, less-stressed staff, and, most importantly, increased revenue and upfront payments.

Historically, the financial element of having surgery has been highly stressful for patients. In many cases, patients put off having life-improving procedures because they cannot understand what it will cost them. In other cases, patients move forward with the procedure but lose sleep, not knowing what bill will come next and for how much. This causes significant tension between patients, providers, staff, payors, and everyone in between. The No Surprises Act will directly help improve this relationship and make it more harmonious and beneficial for everyone.

Further proving the need for legislation is an alarming statistic from GoFundMe. The crowdfunding platform has reported that one-third of the $5 billion raised over the past nine years has gone towards medical expenses. This is because so many consumers are drowning in medical debt and unexpected bills that they have nowhere else to turn. The No Surprises Act will help bring that number down significantly.

Here are three patient stories that will remind everyone why the No Surprises Act is so important.

Drew Calver – Austin, TX

Mr. Calver suffered a heart attack in his home. His neighbor rushed him to the nearest hospital. Unfortunately for Mr. Calver and his family, the hospital his neighbor chose was out of network, and he was sent a bill for $108,951.31. After considerable negative press, the hospital reduced Mr. Calver’s bill to just $331. Read the full story.

The Dean Family – Pulaski, TN and Columbia, TN

Jason Dean had a piece of sheet metal slice his finger while at work. He found a local emergency room, stayed for 30 minutes, received six stitches, and was sent a bill for $6,589.77. Mr. Dean and his wife DeeAnn, were speechless – how could that be? Shortly afterward, Mrs. Dean got terribly sick. She was so scared of going to a hospital and receiving an outrageous bill she waited as long as she could and eventually had her parents drive her hours to a different hospital. Due to the fear of debt, this decision to wait almost cost Mrs. Dean her life as she was days away from organ failure. Read the full story.

Ethan Hassanzai – Rancho Palos Verdes, CA

Mr. Hassanzai is a disabled 18-year old who has dealt with health issues his entire life. He began having seizure-like symptoms, and his mom believed his shunt had become clogged. When they arrived at the emergency room, the doctor called for an ambulance to take Mr. Hassanzai to a more qualified hospital. It was an air ambulance that the doctor called, and the Hassanzai family was sent a bill for $51,000 after their health insurance company denied the claim, arguing that the use of a helicopter wasn’t medically necessary (despite being called by the doctor). Read the full story.

Are you looking for more stories? NPR has a Bill of the Month series to dive in and dissect various medical bills. Due to the amount of press these stories receive, most bills get dropped or significantly reduced to avoid bad press and unwanted attention. Patients are encouraged to submit their bills for review.