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CHAFA Industry Resources

The Centers for Medicare & Medicaid Services No Surprises Act

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Ending Surprise Medical Bills

See how new rules help protect people from surprise medical bills and remove consumers from payment disputes between a provider or health care facility and their health plan

Policies & resources

Review rules and fact sheets on what No Surprises rules cover, and get additional resources with more information.

Resolving out-of-network payment disputes

Learn about out-of-network payment disptes between providers and health plans and how to start the independent dispute resolution(IDR) process.

Consumers

Learn about rights and protections for consumers to end surprise bills and remove consumers from payment disagreements between their providers, health care facilities and health plans.

Explainers for Consumers

The following resources can help consumers understand their new protections:

Complaints about medical billing

Starting in 2022, insurance companies and plans, providers, and health care facilities must follow new rules that protect consumers from surprise medical bills. If you have a question about these rules or believe the rules aren’t being followed, contact the No Surprises Help Desk at 1-800-985-3059 to submit your question or a complaint. Or, you can submit a complaint online, below. We may ask you to provide supporting documentation like medical bills and your Explanation of Benefits. We’ll send a confirmation email when we receive your complaint to notify you of next steps and let you know if we need any additional information. To check on the status of a complaint, or to see what documentation is needed, contact the No Surprises Help Desk.
What we can do
What we can’t do
Review your complaint to make sure your insurance company, medical provider, or health care facility followed surprise billing rules.
Require medical providers or health care facilities to adjust their charges.
Investigate and enforce federal laws and policies under our jurisdiction.
Act as your lawyer or give you legal advice.
Try to find patterns of problems that may need further review.
Make medical judgments or determine if further treatment is necessary.
Help you understand what documentation you need to submit or what next steps you should take.
Determine the value of a claim, or the amount owed to you.
Help answer your questions or direct you to someone who can.
Address issues we can’t legally enforce.

Filing complaints about a doctor, hospital, or provider

You may have a complaint about improper care (like claims of abuse to a nursing home resident) or unsafe conditions (like water damage or fire safety concerns). To file a complaint about improper care or unsafe conditions in a hospital, home health agency, hospice, or nursing home, contact your State Survey Agency. The State Survey Agency is usually part of your State’s department of health services.
To file a complaint about conditions at a hospital (like rooms being too hot or cold, cold food, or poor housekeeping) contact your State’s department of health services.
To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board.
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