Balance Billing Laws in Georgia
Your medical billing rights and protections in Georgia.
Georgia enacted SB 359 (2020), the 'Balance Billing Consumer Protection Act,' which prohibits balance billing for emergency services at both in-network and out-of-network facilities, and for non-emergency services when a patient does not have a meaningful choice of provider. The law includes a dispute resolution process for provider-insurer payment disagreements.
Key Protections in Georgia
Emergency services: Patients cannot be balance billed for emergency services; cost-sharing limited to in-network amounts
Out-of-network at in-network facility: Protections apply for non-emergency services when patients have no meaningful choice of provider
Dispute resolution: Georgia law provides a mandatory arbitration process for provider-insurer payment disputes
Disclosure: Providers must disclose when they are out-of-network and obtain patient acknowledgment for non-emergency services
Filing Information
Within 1 year of receiving the bill for state-level complaints
Additional Notes
Georgia's Balance Billing Consumer Protection Act took effect January 1, 2021. Self-funded employer plans are not covered by state law; federal NSA applies to those plans.
How to File a Complaint in Georgia
Gather Your Documentation
Collect your itemized medical bill, Explanation of Benefits (EOB) from your insurer, any prior authorization documents, and written communications with the provider or insurance company.
File with the State Regulator
Submit your complaint to the Georgia Office of Commissioner of Insurance and Safety Fire. Include all supporting documents and a clear description of the billing dispute.
File complaint with Georgia Office of Commissioner of Insurance and Safety FireFile with CMS if Federal Protections Apply
If your dispute involves the No Surprises Act (emergency care or out-of-network providers at in-network facilities), you can also file directly with the Centers for Medicare & Medicaid Services.
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