Surprise Bill Exclusion; Requirements

  1. Law
  2. Georgia Code
  3. Insurance
  4. Surprise Billing Consumer Protection Act
  5. Surprise Bill Exclusion; Requirements

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  1. Nothing in this chapter shall reduce a covered person's financial responsibilities in the event that such covered person chose to receive nonemergency medical services from an out-of-network provider. Such services shall not be considered a surprise bill for purposes of this chapter.
  2. The covered person's choice described in subsection (a) of this Code section must:
    1. Be documented through such covered person's written and oral consent in advance of the provision of such services; and
    2. Occur only after such person has been provided with an estimate of the potential charges.
  3. If during the provision of nonemergency medical services, a covered person requests that the attending provider refer such covered person to another provider for the immediate provision of additional nonemergency medical services, such referred provider shall be exempt from the requirements in subsection (b) of this Code section if the following requirements are satisfied:
    1. The referring provider advises the covered person that the referred provider may be a nonparticipating provider and may charge higher fees than a participating provider;
    2. The covered person orally and in writing acknowledges that he or she is aware that the referred provider may be a nonparticipating provider and may charge higher fees than a participating provider;
    3. The written acknowledgment referenced in paragraph (2) of this subsection shall be on a document separate from other documents provided by the referring provider and shall include language to be determined by the Commissioner through rule and regulation; and
    4. The referring provider records the satisfaction of the requirements in paragraphs (1), (2), and (3) of this subsection in the covered person's medical file.

(Code 1981, §33-20E-7, enacted by Ga. L. 2020, p. 210, § 1/HB 888.)


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