No Surprises Act
Federal protections against certain surprise out-of-network bills, plus good-faith estimates.
Get a Free Billing AuditDefinition
The No Surprises Act is a federal law that protects patients from many surprise out-of-network bills, such as for emergency care and certain services received at in-network facilities. In these situations, patients are generally protected from balance billing beyond their in-network cost-sharing.
It also requires good-faith estimates of expected charges for uninsured and self-pay patients, so people can understand costs before care.
Why it matters for billing
The No Surprises Act changes how out-of-network situations and self-pay estimates must be handled. Building good-faith estimates and correct patient cost-sharing into the workflow keeps a practice compliant and avoids disputes.
Related terms
Terms that come up alongside No Surprises Act in the revenue cycle.
Billing that gets No Surprises Act right
EnVisionMD RCM handles eligibility, coding, documentation, denials and follow-up end to end — so the details behind terms like this one are managed for you, not left to chance.
Request a free billing reviewNo Surprises Act — frequently asked questions
Many surprise out-of-network bills, such as emergency care and certain services at in-network facilities, limiting patients to in-network cost-sharing in those cases.
An estimate of expected charges that must be provided to uninsured and self-pay patients so they can understand costs before care.