No Surprises Act & Patient Billing Protections

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NO SURPRISES ACT & PATIENT BILLING PROTECTIONS
(New Jersey & Federal Compliance Statement)

1. Our Commitment
Madison Company (“we,” “our,” or “the Organization”) is committed to full compliance with all applicable federal and State of New Jersey laws governing patient billing transparency, surprise billing protections, and consumer rights. We prioritize clarity, fairness, and patient protection in all financial interactions.

2. Protections Against Surprise Billing

A. Emergency Services
Under both federal law and New Jersey law:

  • Patients receiving emergency services cannot be billed more than their in-network cost-sharing amount, even if services are provided by an out-of-network provider.
  • No prior authorization is required for emergency services.
  • Out-of-network providers may not balance bill patients beyond permitted cost-sharing.

B. Non-Emergency Services at In-Network Facilities
If a patient receives care at an in-network facility but is treated by an out-of-network provider (e.g., anesthesiologist, radiologist, pathologist):

  • The patient may not be balance billed.
  • The patient’s responsibility is limited to in-network cost-sharing.
  • Providers must comply with state and federal notice and consent requirements if applicable.

C. Transparency Requirements
We provide:

  • Clear disclosure of network participation status
  • Good Faith Estimates (for uninsured/self-pay patients)
  • Itemized billing upon request
  • Access to billing representatives for clarification

3. Good Faith Estimates (Uninsured & Self-Pay Patients)
In accordance with federal law:

  • Uninsured or self-pay patients will receive a written Good Faith Estimate prior to scheduled services.
  • Estimates include expected charges for items and services.
  • Patients may dispute bills that substantially exceed the Good Faith Estimate under federal dispute resolution processes.

4. Patient Rights & Dispute Resolution
Patients have the right to:

  • Request a review of potential surprise billing violations
  • File complaints with:
    • The New Jersey Department of Banking & Insurance
    • The Centers for Medicare & Medicaid Services (CMS)
  • Access independent dispute resolution processes where applicable

We fully cooperate with all regulatory review and dispute resolution mechanisms.

5. Accessibility & Non-Discrimination Policy
Madison Company complies with:

  • The Americans with Disabilities Act
  • Section 504 of the Rehabilitation Act
  • Section 1557 of the Affordable Care Act
  • Applicable New Jersey civil rights laws

We do not discriminate on the basis of:

  • Race
  • Color
  • National origin
  • Sex (including pregnancy, sexual orientation, gender identity)
  • Age
  • Disability
  • Religion
  • Marital status
  • Source of payment

6. Accessibility Statement (Website & Services)
We are committed to ensuring digital accessibility for people with disabilities. Our accessibility standards include:

  • Conformance with WCAG 2.1 AA standards
  • Screen reader compatibility
  • Alternative text for images
  • Keyboard navigability
  • Captioned multimedia content

If you experience difficulty accessing any content, please contact us immediately so we can provide accommodations.

7. Auxiliary Aids & Language Assistance
We provide, free of charge:

  • Qualified interpreters
  • Translation of vital documents
  • Auxiliary aids for individuals with disabilities
  • TTY/TDD access where applicable

Patients may request accommodations at any time before or during care.

8. Compliance Oversight & Governance
Madison Company maintains:

  • A designated Compliance Officer
  • Written billing policies and procedures
  • Ongoing staff training on state and federal surprise billing laws
  • Internal audit and monitoring systems
  • Document retention policies in accordance with state and federal requirements

All workforce members are required to adhere to these compliance standards.

9. Reporting & Grievances
Patients, employees, or partners may report:

  • Billing concerns
  • Accessibility barriers
  • Discrimination complaints
  • Compliance violations

Reports may be submitted confidentially and without fear of retaliation.

10. Policy Updates
This policy is reviewed regularly to ensure compliance with evolving federal and State of New Jersey laws. Updates are posted promptly on our website.

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Your Rights & Protections Against Surprise Medical Bills
When you receive emergency care or are treated by an out-of-network provider at an in-network facility, you are protected from surprise billing under federal law and New Jersey law. You are only responsible for in-network cost-sharing amounts. Contact us for more information or to receive a Good Faith Estimate.