Balance Billing Laws in South Carolina
Your medical billing rights and protections in South Carolina.
South Carolina enacted the Surprise Billing Consumer Protection Act (Act 228 of 2022 / S.C. Code § 38-71-2410 et seq.), which prohibits balance billing for emergency services and for non-emergency care at in-network facilities when patients have no meaningful choice of provider. The law, effective January 1, 2023, establishes notice requirements, patient cost-sharing protections, and a dispute resolution process for provider-insurer payment disagreements.
Key Protections in South Carolina
Emergency services: S.C. Code § 38-71-2420 prohibits balance billing for emergency services at any facility, in-network or out-of-network; patients pay only their in-network cost-sharing amount
Non-emergency care at in-network facilities: Patients cannot be balance billed by out-of-network providers at in-network facilities for non-emergency services without at least 72 hours' advance written notice and written patient consent
Independent dispute resolution: South Carolina uses the federal IDR process; provider-insurer disputes are resolved without involving the patient
Good faith estimate: Providers must give uninsured and self-pay patients a good faith estimate of expected charges at least 3 days before the service
Facility notice: Hospitals must post and provide notice of patient rights under the Surprise Billing Consumer Protection Act
Filing Information
Within 60 days of receiving the bill for SC Department of Insurance complaints; within 1 year for federal NSA disputes
Additional Notes
South Carolina's Surprise Billing Consumer Protection Act (Act 228 of 2022) became effective January 1, 2023, and applies to state-regulated fully insured health plans. Self-funded employer plans are covered by the federal No Surprises Act. Consumers can contact SCDOI at 1-800-768-3467 or file a complaint online. The SC Attorney General's Office (803-734-3970) can assist with consumer protection matters. Patients who receive a balance bill should first contact their insurance company, then file with SCDOI if unresolved.
How to File a Complaint in South Carolina
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 South Carolina Department of Insurance (SCDOI). Include all supporting documents and a clear description of the billing dispute.
File complaint with South Carolina Department of Insurance (SCDOI)File 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.
File with CMS No Surprises Help DeskComprehensive Medical Billing Rights Guide for South Carolina
We've written a detailed guide covering all of South Carolina's patient rights, balance billing protections, and step-by-step dispute process — including specific state agencies and timelines.
Read the South Carolina Patient Rights GuideRelated Articles
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