Disputing a Medical Bill in Georgia
Medical Billing Laws, Consumer Protections & Information
Georgia
The State of Georgia gives consumer protections and has other laws and regulations for patients receiving care from, or otherwise being billed by, a provider in the state. Here are some of the most important state-specific laws and protections related to medical billing in Georgia.
BALANCE BILLING - NETWORK FACILITY
Insured patients in Georgia have protections at both the state and federal levels against surprise billing, including by a non-participating provider when the patient was treated at a participating network hospital or facility.
OUT-OF-NETWORK PROVIDER BILLING
A bill from a Georgia provider not participating in an insured patient's provider network is considered a surprise bill unless the non-participating provider does the following:
- Provide the patient with an estimate of the potential charges; and
- Document the patient's advance written and oral consent to pay the estimated charges.
OUT-OF-NETWORK EMERGENCY SERVICES
A Georgia hospital or facility not participating in an insured patient’s insurance network may not bill the patient for emergency services more than such patient's deductible, coinsurance, copayment, or other cost-sharing amount as determined by such patient’s insurance plan.
PRICE TRANSPARENCY
41%
Only 41% of the hospitals in Georgia are compliant with the federal Hospital Price Transparency Rule requiring hospitals to publish their prices, according to an independent audit. If you received a bill from a non-compliant hospital, that can be a reason to dispute the bill.
MEDICAL DEBT IN GEORGIA
12.7%
12.7% of people in Georgia report having medical debt in a given year, on average.
HOSPITAL PRICES
4.5 x cost
The average hospital in Georgia charges 4.5 times what it costs to render the services. That means for every $100 in cost, it bills $450, of which $350 is profit.
Medical Billing Laws & Consumer Protections
All of U.S.
These federal laws and consumer protections apply to
all 50 U.S. states and the District of Columbia.
NO SURPRISE BILLING
The No Surprises Act protects people using insurance from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
GOOD FAITH ESTIMATE
A medical provider must issue a Good Faith Estimate in advance of services to a patient not using insurance. The Good Faith Estimate is a disclosure of expected services to be rendered and their charges.
BALANCE BILLING - EMERGENCY
A provider may not bill an insured patient for emergency services above the in-network payment responsibilities (coinsurance, deductible, copayment) under insurance benefits.
BALANCE BILLING - AT AN IN NETWORK FACILITY
For services an insured patient receives while visiting a participating hospital or facility, a provider may not bill the patient above the in-network payment responsibilities (coinsurance, deductible, copayment) under insurance benefits.
COLLECTIONS PROTECTIONS
The three nationwide credit reporting companies – Equifax, Experian, and TransUnion – do not include medical debts (1) below $500, or (2) less than a year old on consumer credit reports.
Dispute your problem medical bill now.
You have so much to gain by finding out if Patient Fairness can help with your problem medical bill. Complete the Problem Medical Bill Assessment and we'll tell you if we identified opportunities to question and/or dispute the medical bill. We'll even suggest some ways to dispute or reduce the medical bill if we can't help.