Sometimes, Fidelis Care members at network hospitals or ambulatory surgical centers will receive health services from providers who do not participate in the Fidelis Care Network. In this case, the resulting bill is NOT always considered a surprise bill.
If you go to a network facility, but receive care from an out-of-network provider, it's only a surprise bill if:
- A participating provider was not available; or
- A non-participating provider administered health services without your knowledge; or
- Unforeseen medical circumstances arose at the time the healthcare services were provided.
It is NOT a surprise bill if you chose to receive services from a non-participating provider instead of from an available participating provider.