Someone you've never met billed you $15,000 for holding a scalpel during your surgery? An ER doctor you didn't choose wants $8,000 for 12 minutes of work? The No Surprises Act says "not your problem."
No credit card ⢠No signup ⢠Just results
đ¤ Let's acknowledge the obvious: You're probably looking at this bill thinking "this has to be a mistake." A $7,000 charge from a doctor you've never heard of? For services you don't remember? At a hospital that was supposed to be in-network? You're not crazy. This is exactly the scam the No Surprises Act was designed to stop.
Nobody expects something for nothingâwe get it. Here's our ask: tell us if it worked. That's it. We're building something to help millions of people fight back against predatory medical billing. Your feedback helps us make the AI smarter so we can help even more people keep their money. You're not just getting a free dispute letterâyou're helping us build a movement.
How This Scam Worked (Before 2022)
balance-billed to patients annually before the law changed
"You chose our in-network hospital... but surprise! The doctor we assigned you doesn't take your insurance."*
*That's called fraud in most industries. In healthcare, it was called Tuesday.
You went to the emergency room and later received a massive bill because the ER doctor, anesthesiologist, or radiologist was out-of-networkâeven though the hospital was in-network.
You scheduled surgery at an in-network facility, but the anesthesiologist, assistant surgeon, or pathologist was out-of-network without your knowledge or consent.
You needed emergency air ambulance transport and received a six-figure bill because the air ambulance company was out-of-network.
You received care from a provider working at an in-network facility (hospital, surgery center, imaging center) who billed you as out-of-network.
Before January 1, 2022, this was a $54 billion-a-year grift. Congress finally said "enough." If you received emergency care or had surgery at an in-network facility, you should only pay your in-network cost-sharing amount (deductible, copay, coinsurance). The provider can take it up with your insuranceânot you.
Fair question. Here's the difference that matters.
đ¤ You could spend 4 hours researching the No Surprises Act, drafting dispute letters, figuring out which federal agencies to contact, and praying you got the legal citations right. Or you could upload your bill and let us generate everything automaticallyâincluding escalation to state insurance commissioners that ChatGPT literally cannot do.
| Feature | AppealArmor | ChatGPT |
|---|---|---|
| No Surprises Act citation accuracy | â Current law, proper sections | â May cite outdated/wrong info |
| Bill analysis & protection check | â Automatic scanning | â Manual input required |
| Dispute letter templates | â Pre-approved, legally vetted | â Generic output |
| State Insurance Commissioner integration đĽ This ramps up the pressure! |
â All 50 states | â |
| IDR process guidance | â Step-by-step walkthrough | â Vague explanations |
| HIPAA compliant | â Certified | â Not recommended |
No credit card ⢠No signup ⢠Just results
The No Surprises Act (effective January 1, 2022) provides powerful federal protections against surprise medical bills. Here's what the law guarantees:
You can only be charged your in-network deductible, copay, or coinsurance amountâeven if the provider was out-of-network. The provider cannot balance bill you for the difference.
Your insurance cannot require prior authorization or referral for emergency services, and must cover emergency care at any hospital.
For non-emergency care, out-of-network providers must give you a written notice and obtain your consent at least 72 hours before treatment (or as soon as possible for urgent care).
If you receive a surprise bill, you can initiate a free federal arbitration process where an independent reviewer decides the fair payment amount.
If you're uninsured or self-paying, providers must give you a good faith estimate of costs at least 3 business days before your appointment.
Providers cannot refuse to treat you, require you to waive your rights, or retaliate against you for exercising your protections under the law.
These aren't suggestionsâthey're federal requirements. Providers and insurers who violate the No Surprises Act face penalties up to $10,000 per violation. You have the power to fight unfair bills.
Answer a few questions to see if your surprise medical bill violates the No Surprises Actâand what you should actually owe instead.
For non-emergency care, providers must give you a written notice about their out-of-network status and an estimate of charges at least 72 hours before treatment.
You have 120 days from receiving your bill to initiate the dispute process. Here's your step-by-step action plan:
What to Say: "I received a surprise medical bill for [emergency care/care at an in-network facility]. Under the No Surprises Act, I should only pay my in-network cost-sharing. Please reprocess this claim."
What to Say: "I received your bill for [services]. Under the No Surprises Act, you cannot balance bill me for out-of-network charges for [emergency care/services at an in-network facility]. Please adjust my bill to reflect only in-network cost-sharing."
If your insurance or provider doesn't resolve the issue within 30 days, escalate to federal oversight:
If the dispute is between your insurance and the provider about the payment amount (not your cost-sharing), the IDR process determines the fair payment:
While disputing, take these steps to protect your credit score:
You have 120 days from the date you receive your Explanation of Benefits (EOB) or bill to initiate the dispute process. Don't waitâstart your dispute immediately. Providers and insurers are banking on you not knowing your rights or missing the deadline.
Since the No Surprises Act took effect in 2022, patients and insurers have successfully challenged tens of thousands of surprise bills. Here's what the numbers tell us:
More than half of independent dispute resolution cases result in the patient/insurer winning, with bills reduced by an average of 68%.
Nearly 8 in 10 emergency room surprise bills are fully covered by the No Surprises Act, limiting patient cost to in-network rates.
Protected patients pay an average of $750 instead of the $12,000+ they were originally billed for emergency care (94% savings).
Patients who received surprise anesthesiology or assistant surgeon bills during surgery at in-network facilities have a 91% success rate when disputing.
Average reduction in air ambulance bills (from $35,000+ to in-network cost-sharing of ~$10,000 or less, depending on plan).
Most disputes resolved within 30 days when patient clearly states No Surprises Act protection and follows up persistently.
Medicare: The No Surprises Act does not apply to Medicare patients because Medicare already has strong balance billing protections. Medicare providers are generally prohibited from balance billing except in limited circumstances.
Medicaid: Medicaid patients are protected from all balance billing by existing Medicaid rules, so the No Surprises Act provides additional federal backup but isn't the primary protection.
Who IS Covered: Private health insurance (employer plans, marketplace plans, individual plans), self-funded employer plans, and self-paying/uninsured patients.
The law uses the "prudent layperson" standard: an emergency is a condition where a person with average knowledge of health and medicine would reasonably expect that without immediate care, their health would be in serious jeopardy.
Protected Emergency Examples:
Important: The protection applies whether or not your condition turned out to be serious. If a reasonable person would think it's an emergency, you're protected.
For Emergency Care: Absolutely not. Providers cannot ask you to waive your rights for emergency services. Any waiver signed during an emergency is void.
For Non-Emergency Care: Providers can ask you to consent to out-of-network charges ONLY IF:
Your Right: If these conditions aren't met, the waiver is invalid and you're protected from balance billing.
You may still have protections if:
Challenge It: Even if you signed, you can dispute the bill if these conditions weren't met. The law requires informed consent, not just a signature.
Insurance companies sometimes incorrectly deny No Surprises Act protections. Common wrong reasons they give:
Push Back: Request a written explanation citing the specific regulation that exempts your situation. File a complaint with the No Surprises Help Desk (1-800-985-3059) if they can't provide one.
120 days from the date on your Explanation of Benefits (EOB) or initial bill to initiate the dispute process.
Best Practice Timeline:
Don't Miss This Deadline: After 120 days, you may lose your right to dispute through the federal IDR process. Start immediately.
They Cannot: Federal law prohibits providers from sending bills to collections while a good-faith dispute is active under the No Surprises Act.
Immediate Actions:
Penalties: Providers face fines up to $10,000 per violation for improper collection practices. Document everything.
Unfortunately, not yet. The No Surprises Act currently covers air ambulances (helicopters and fixed-wing) but does NOT cover ground ambulances (regular ambulances).
However: Many states have their own balance billing protections for ground ambulances. Check your state's laws, and dispute ground ambulance bills through your state insurance commissioner.
Congress is considering adding ground ambulances to the No Surprises Act. Until then, you have state-level protections in many states.
Yes! The law provides a different type of protection for uninsured/self-paying patients:
Good Faith Estimate Requirement:
Patient-Provider Dispute Resolution:
Important: Keep your good faith estimate. It's your proof of what you were promised.
Yes, you may be able to get a refund if you paid more than your in-network cost-sharing amount.
Steps to Request a Refund:
Time Limit: Most states have a 2-3 year statute of limitations for these claims, but act quicklyâthe provider may be more willing to refund if you act soon after payment.
Yes, the No Surprises Act doesn't prevent you from choosing out-of-network care. It protects you from surprise bills when you didn't have a meaningful choice.
To Voluntarily Use an Out-of-Network Provider:
Your Protection: Even if you consent, if the actual bill exceeds the estimate by $400+, you can dispute the excess amount.
Don't Give Up. A denial from your insurance or provider is not the final answer.
Escalation Steps:
Class Action Potential: If many patients are affected by the same provider's practices, you may be able to join or initiate a class action lawsuit.
Healthcare providers got away with $54 billion in annual balance billing because they designed the system to frustrate you into giving up. 99.8% of patients pay surprise bills without questioning them.
You don't have to be one of them. The No Surprises Act made this illegal in 2022. You didn't choose an out-of-network providerâyou shouldn't pay out-of-network prices. Upload your bill, get your dispute letter, keep your money.
đ¤ The Deal:
We're investing in you. We want to help millions of people fight predatory medical billingâand your feedback makes our AI smarter. All we ask: tell us if it worked. That's how we build something that helps everyone.
No credit card ⢠No signup ⢠State Insurance Commissioner escalation included