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If you’re a member of an HMO or PPO Health Plan in California
it is against the law for emergency care doctors or hospitals
to bill you for amounts not covered by your health insurance.
This practice is called balanced billing.
If you have an emergency, a medical emergency
and you believe it would require immediate emergency attention
and you went to a hospital
and you were seen in the emergency room
and you then received a bill for that service
if you dispute that with the health plan
the emergency room provider is not allowed to
bill you for anything that the health plan does not reimburse them for
That would be a balanced billing.
That’s illegal in California.
The Help Center can take action on behalf of patients against doctors and health plans
who engage in unfair balance billing.
To learn more about the Help Center
visit the website at HealthHelp.CA.GOV
or call 1-888-466-2219
For more information and resources
about getting the most out of your health care
visit the Office of the Patient Advocate’s website at
OPA.CA.GOV