Here are the key guidelines and laws related to medical billing in Kentucky:Surprise Medical Bills

• The federal No Surprises Act, effective January 1, 2022, bans surprise billing for emergency services and certain non-emergency services at in-network facilities. It prohibits out-of-network charges and balance billing without advance notice.
• The law applies to people covered under employer-sponsored and individual/family health plans. Those with Medicare, Medicaid, TRICARE, VA health care or Indian Health Services are already protected.
• Patients cannot be asked to pay more than the in-network rate their insurer would typically charge. Any coinsurance or deductible must be based on in-network provider rates.
• Kentuckians with a surprise billing complaint can contact the federal "No Surprises Help Desk" at 800-985-3059 or the Kentucky Department of Insurance at 800-595-6053.

Itemized Billing Statements

• Kentucky law requires health facilities to provide paying patients with a free copy of their itemized statement within 30 days of discharge or 15 days of request, whichever is later.
• The statement must be stamped "Kentucky Revised Statutes prohibit the use of this statement for insurance payment purposes where benefits have been assigned."
• Facilities must post notices that itemized statements are available upon request.
• If a facility knows of a discrepancy in total charges reported to a third-party payor, they must provide the patient and payor with notification and explanation.

Uninsured and Self-Pay Patients

• The No Surprises Act requires providers to give uninsured and self-pay patients a good faith estimate of expected charges before scheduled services.
• If the final bill is at least $400 higher than the estimate, the patient can initiate a patient-provider dispute resolution process.
• Providers must offer an itemized list of each service with details like the code and expected charge.

While the No Surprises Act provides important new protections, it does not address surprise bills from ground ambulances. Kentucky should consider passing additional state laws to fully protect consumers from unexpected medical costs.