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No Surprises Act
No Surprises Act/Transparency Under the Consolidated Appropriations Act, 2021 Information
Medical Mutual Services is committed to full compliance with federal law and regulations concerning surprise billing and transparency in coverage.
These files are not designed as a consumer tool. Members are encouraged to use the more member-friendly price estimator tools available through the health
plan's public website. These files are not a guarantee of coverage, nor a
guarantee of the reimbursement rate that will be applied for any procedure. The
claims reimbursement process is subject to a variety of factors that are not
addressed in these files, including eligibility, medical necessity
determinations, utilization management requirements, exclusions and other plan
terms. These files also do not offer any information on a member's out-of-pocket
charges. The information in these files is accurate as of the date noted for
each file and is subject to change without notice.