Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

MOLECULERA LABS IS OUT-OF-NETWORK WITH ALL INSURANCE CARRIERS.

The full cost of the Cunningham Panel™ of Tests is $995 (within the contiguous United States). For patients outside the contiguous United States, please contact us at +1 (405) 239-5250 or via email at customerservice@moleculera.com for a Good Faith Estimate.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

State-Specific Rules

Some states have their own laws relating to balance or surprise billing for out-of-network laboratory services that may be different from those described by the No Surprises Act. The links below contain state specific balance billing information and resources, including contact information for state agencies that may be able to help you further.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network.

When balance billing isn’t allowed, you also have the following protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
    • Cover emergency services by out-of-network providers.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in network provider or facility and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you think you’ve been wrongly billed: you may file a complaint with the federal government at https://www.cms.gov/nosurprises/consumers or by calling 1-800-985-3059; and/or file a complaint with your state balance billing regulator, if any, which is identified in the state-specific tabs.

Visit https://www.cms.gov/nosurprises for more information about your rights under federal law or visit your home state regulator’s website (included in state links above) for more information about your state balance billing rights.

ARIZONA RESIDENTS

ARIZONA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING, CONTACT OR VISIT: 

Arizona Department of Insurance and Financial Institutions
Address: 100 N. 15th Ave. Ste. 261, Phoenix, AZ 85007-2630
Phone:  (602) 364-3100
E-mail: soonbdr@azinsurance.gov
Website: https://difi.az.gov/soonbdr

Back to Top

CALIFORNIA RESIDENTS

CALIFORNIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

California Department of Insurance
Phone:  1-800-927-4357
website: https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm  or 
http://www.insurance.ca.gov/01-consumers/101-help/index.cfm

Back to Top

COLORADO RESIDENTS

COLORADO LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Office of the Attorney General
Address: 1300 Broadway, 10th Floor, Denver, CO 80203
Telephone: (720) 508-6000
Website: https://coag.gov/file-complaint/

Back to Top

CONNECTICUT RESIDENTS

CONNECTICUT LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

The State of Connecticut does not have a state balance billing enforcement program or maintain publicly available information about its balance billing laws.

Back to Top

DELAWARE RESIDENTS

DELAWARE LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Delaware Department of Insurance
Phone: 1-800-282-8611 (In Delaware Only) Or (302) 674-7310
Email: consumer@delaware.gov
website: https://insurance.delaware.gov/services/filecomplaint/

Back to Top

FLORIDA RESIDENTS

FLORIDA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING (HYPERLINK BACK TO THE GENERAL NSA BILLING RIGHTS IN THE EVENT A FL RESIDENT LANDS HERE.)

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Florida has not designated a surprise billing enforcement agency.

Back to Top.

GEORGIA RESIDENTS

GEORGIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Office of Commissioner of Insurance
Address: 2 Martin Luther King Jr. Dr., West Tower, Suite 702, Atlanta, GA 30334
Telephone: (404) 656-2070
Website: https://oci.georgia.gov/

Back to Top

ILLINOIS  RESIDENTS

ILLINOIS LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

The Illinois Department of Insurance
Phone: (877) 527-9431
website: https://www2.illinois.gov/sites/Insurance/consumers/Pages/default.aspx

Back to Top

INDIANA RESIDENTS

INDIANA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Indiana Department of Insurance, Consumer Service Department
Address: 311 West Washington Street, Suite 300, Indianapolis, IN 46204-2787
Telephone: 1-800-622-4461  
Email: consumerservices@idoi.in.gov
websites: https://content.govdelivery.com/accounts/INDOI/bulletins/29ac870 OR
https://www.in.gov/idoi/consumer-services/

Back to Top

MAINE RESIDENTS

MAINE LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Maine Bureau of Insurance
Address: 34 State House Station, Augusta, ME 04333
Telephone: 207-624-8475
Email: insurance.pfr@maine.gov
website: https://www.maine.gov/pfr/insurance/

Back to Top

MARYLAND RESIDENTS

MARYLAND LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

The Maryland Insurance Administration
Address: 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202 
Telephone: 410-468-2000 
E-mail: insurance.mia@maryland.gov
Websites: www.insurance.maryland.gov  or
https://insurance.maryland.gov/Consumer/Documents/publications/AssignmentofBenefitsFAQ.pdf

Back to Top

MASSACHUSETTS RESIDENTS

MASSACHUSETTS LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Health and Human Services of the Commonwealth of Massachusetts
Address: 1 Ashburton Place, 11th Floor Boston, Massachusetts 02108 
Telephone: (617) 573-1600
Email: marylou.sudders@state.ma.us

Back to Top

MICHIGAN RESIDENTS

MICHIGAN LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:

Michigan Department of Insurance and Financial Services
Hotline: 877-999-6442
Websites: https://www.michigan.gov/difs/0,5269,7-303-13222_13250-561696–,00.html
https://www.michigan.gov/DIFScomplaints

Back to Top

MISSISSIPPI RESIDENTS

MISSISSIPPI LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Mississippi Insurance Department, Office of the Insurance Commissioner
Address: Mississippi Insurance Department, P.O. Box 79, Jackson, MS 39205
Telephone: 601-359-3569
Email: mike.chaney@mid.ms.gov
http://www.mid.ms.gov  or 
http://www.mid.ms.gov/healthcare/questionsanswers/TopicTwo.pdf

Back to Top

MISSOURI RESIDENTS

MISSOURI LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Missouri Department of Insurance
Address: PO Box 690, Jefferson City, MO 65102-0690
Telephone: (573) 751-4126
Email: news@difp.mo.gov
website: https://insurance.mo.gov/consumers/health/managingcost.php

Back to Top

NEBRASKA RESIDENTS

NEBRASKA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Nebraska Department of Insurance
Phone: 402-471-2201, or call our toll-free consumer hotline at 1-877-564-7323. Additional information is available on our website at.
Websites www.doi.nebraska.gov
https://doi.nebraska.gov/sites/doi.nebraska.gov/files/doc/ConsumerFactSheetBalanceBillingandOutofNetworkProviders.pdf or
https://doi.nebraska.gov/consumer/consumer-assistance

Back to Top

NEVADA RESIDENTS

NEVADA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Nevada Department of Insurance 
Consumer Compliance & Licensing 
1818 E. College Pkwy., Suite 103
Carson City, NV 89706
Phone: (775) 687-0700 
website: https://doi.nv.gov/Consumers/Health_and_Accident_Insurance/Balance_Billing_FAQs/

Back to Top

NEW HAMPSHIRE RESIDENTS/h3>

NEW HAMPSHIRE LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

New Hampshire Insurance Department
Address: 21 South Fruit Street, Suite 14, Concord, NH 03301
Telephone: 1 (800) 852-3416
Email: consumerservices@ins.nh.gov
websites: https://www.nh.gov/insurance/consumers/ or
https://www.nh.gov/insurance/consumers/documents/20211210-nsa-faq-consumers-producers.pdf

Back to Top

NEW JERSEY RESIDENTS

NEW JERSEY LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

New Jersey Department of Banking and Insurance
Address: State of 20 West State Street P.O. Box 325 Trenton, New Jersey 08625-0325
Telephone: (609) 292-7272
Email: marlene.caride@dobi.nj.gov
website: https://www.state.nj.us/dobi/division_consumers/insurance/outofnetwork.html

Back to Top

NEW MEXICO RESIDENTS

NEW MEXICO LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT:

New Mexico Licensing and Regulation Department
Address: PO Box 25101, Santa Fe, NM 87504
Telephone: (505) 469-0982
Email: linda.trujillo@nmlegis.gov
website: https://www.osi.state.nm.us/

Back to Top

NEW YORK RESIDENTS

For patients in New York, if your insurance ID card says “fully insured coverage,” surprise bills include when your in-network doctor refers you to an out-of-network provider without your consent (including lab and pathology services). These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. You may need to sign a form (available on the Department of Financial Services’ website) for the full balance billing protection to apply. These rights and protections are different from those described in YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

New York State Department of Financial Services
Address: 1 State Street, New York, NY 10004-1511
Telephone: (800) 342-3736
E-mail: consumers@dfs.ny.gov
Surprisemedicalbills@dfs.ny.gov
Websites: http://www.dfs.ny.gov  or

Back to Top

OHIO RESIDENTS

OHIO LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Ohio Department of Insurance
50 W Town Street Suite 300, Columbus Ohio 43215 
Phone: 800-686-1526
website: https://insurance.ohio.gov/strategic-initiatives/surprise-billing

Back to Top

OREGON RESIDENTS

OREGON LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Department of Consumer and Business Services, 
Division of Financial Regulation
Address: P.O. Box 14480, Salem, OR 97309-0405
Telephone: 888-877-4894
Website: https://www.oregon.gov/dcbs/pages/index.aspx

Back to Top

PENNSYLVANIA RESIDENTS

PENNSYLVANIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Pennsylvania Department of Insurance 
Address: 1326 Strawberry Square, Harrisburg, PA 17120
Telephone: (717) 787-0872
Website: https://www.pa.gov/ or
https://pennpirg.org/sites/pirg/files/resources/PennPIRG%20Surprise%20Billing%20tip%20sheet_formatted.docx_.pdf

Back to Top

TEXAS RESIDENTS

TEXAS LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Texas Department of Insurance
Phone: 800-252-3439
website: https://www.tdi.texas.gov/tips/texas-protects-consumers-from-surprise-medical-bills.html

Back to Top

VIRGINIA RESIDENTS

Consumers covered under (i) fully-insured policies issued in Virginia, (ii) the Virginia state employee health benefit plan; or (ii) as self-funded group or plan that opted in to the Virginia protections area also protected from balance billing under Virginia law.  These protections may different from the ones provided by the federal law as described in YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

The State Corporation Commission Bureau of Insurance
Address: Bureau of Insurance – SCC, P.O. Box 1157, Richmond, Virginia 23218
Telephone: 877-310-6560
Email: bureauofinsurance@scc.virginia.gov
Websites: https://scc.virginia.gov/pages/Balance-Billing-Protection
Scc.virginia.gov/pages/File-Complaint-Consumers

Back to Top

WASHINGTON RESIDENTS

WASHINGTON LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Washington Office of the Insurance Commissioner
Phone: 800-562-6900
websites: https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status or
https://www.insurance.wa.gov/what-consumers-need-know-about-surprise-or-balance-billing

Back to Top

WEST VIRGINIA RESIDENTS

WEST VIRGINIA LAW MAY PROVIDE PROTECTIONS TO YOU AND ALLOW MOLECULERA TO BILL YOU FOR AMOUNTS THAT ARE DIFFERENT FROM THOSE PROVIDED BY THE FEDERAL LAW AS DESCRIBED IN YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLING 

FOR MORE INFORMATION REGARDING YOUR PROTECTIONS AGAINST SURPRISE BILLING OR TO LEARN ABOUT MAKING A COMPLAINT CONTACT OR VISIT: 

Offices of Insurance Commissioner
Address: West Virginia Offices of the Insurance Commissioner, P.O. Box 50540 Charleston, West Virginia 25305-0540
Telephone: (304) 558-3354
Email: jim@jimdodrill.com
website: https://www.wvinsurance.gov

Back to Top

The contents herein do not have the force and effect of law and are not meant to bind the public in any way, unless specifically incorporated into a contract. This information is intended only to provide clarity to the public regarding existing requirements under the law.