Bill Savior
Anthem Blue Cross

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Getting treated at an in-network facility does not guarantee all your providers are in-network. Anthem members routinely receive surprise bills from out-of-network doctors they never chose. Here is what to do about it.

The No Surprises Act, which took effect in January 2022, provides strong protections against surprise out-of-network bills for emergency services and non-emergency care at in-network facilities. However, Anthem members still encounter balance bills in situations the law does not fully cover, and many patients do not know their rights under these federal protections. Understanding where the law applies — and where it does not — is the first step toward avoiding unnecessary charges on your Anthem statement.

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How Out-of-Network Charges Sneak Into Anthem Bills

Even at an in-network hospital, the anesthesiologist, pathologist, or radiologist may not participate in your Anthem plan. When that happens, those providers can bill you the difference between their charge and what Anthem paid — a practice called balance billing. While the No Surprises Act prohibits this in many cases, violations still occur, and patients who do not recognize the illegal charges often pay them without questioning.

Protect Your Wallet: Get Anthem Bills Audited

  1. Send your Anthem bill and Explanation of Benefits to Bill Savior, including any out-of-network charges you were not expecting.
  2. We determine whether the No Surprises Act applies, identify billing errors, and negotiate directly with the provider to reduce or eliminate illegal charges.
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How to Avoid and Fight Anthem Out-of-Network Charges

Ask every provider before a procedure whether they are in-network with your specific Anthem plan — this includes anesthesiologists and lab services.

Review your Anthem EOB for any charges listed as out-of-network when you received care at an in-network facility, as these may violate the No Surprises Act.

File a complaint with the No Surprises Help Desk at 1-800-985-3059 if you received a prohibited balance bill from an Anthem-covered service.

Let Bill Savior review all Anthem charges for No Surprises Act violations and negotiate reductions on any legitimate out-of-network balances.

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Does the No Surprises Act protect me on all Anthem plans?

The No Surprises Act applies to most group and individual health plans, including many Anthem plans. It covers emergency services, non-emergency care from out-of-network providers at in-network facilities, and out-of-network air ambulance services. Self-funded employer plans may have different rules.

What if my Anthem provider was out-of-network but I did not choose them?

If you received care from an out-of-network provider at an in-network facility and did not consent to the out-of-network care in advance, the No Surprises Act generally protects you from balance billing. Bill Savior can review your specific situation and dispute any prohibited charges.

Can Bill Savior negotiate my Anthem out-of-network bill even if the charges were technically allowed?

Yes. Even when out-of-network charges are legal under your plan, Bill Savior can negotiate directly with the provider for a reduced balance, prompt-pay discount, or financial hardship adjustment.

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