No Surprises Act

Under the No Surprises Act which went into effect on 1/1/2022, patients are entitled to certain notifications from providers as follows below:

Good Faith Estimates
If you have no insurance or are electing to have a procedure provided without using your insurance, you are considered “Self Pay” and are eligible to receive a Good Faith Estimate for the services you will be provided.

No Surprises Act
If you are being seen at an “In Network” facility (your hospital or doctors’ office) and have services provided by an “Out of Network” provider (pathology, radiology, anesthesiology, etc.), the No Surprises Act offers you certain protections prohibiting the provider from “balance billing” for their services. The provisions of this regulation are complex and should be discussed with the provider’s office. Iowa Pathology Associates participates with most major insurances in Iowa. Here is a short list of those insurances:

  • Medicare/Tricare
  • Medicaid (including traditional, Iowa Total Care and Amerigroup)
  • Wellmark Blue Cross/Blue Shield (includes PPO and Wellmark Health Plan HMO)
  • United Healthcare
  • Aetna
  • Midlands Choice
  • Health Partners

There are many other insurances/TPA’s that we participate with and a full list can be found on the document link below entitled Insurance Participation for Iowa Pathology Associates. If your insurance is considered “In Network”, then the provisions of the No Surprises Act do not apply.

If you would like a Good Faith Estimate or have questions about any information in this notice, please reach out to Iowa Pathology Associates at 515-241-8866 and tell them that you need to speak to someone about the No Surprises Act.

Insurance Participation for Iowa Pathology Associates

No Surprises Act Handout to Clients and Patients