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Mass. Gen. Laws. Ann. ch. 111, § 228 - Advance disclosure of allowed amount or charge for admission, procedure or service

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Advance disclosure of allowed amount or charge for admission, procedure or service 

A health care provider must disclose the allowed amount and charge of admission or a procedure  and facility charges before a patient is admitted or a procedure is done if the patient requests this information.  If the provider is unable to predict the specific treatment or diagnostic code, the provider must give the patient an estimate of the maximum charge allowed. 

If a patient is covered by a health plan, a provider who is an in-network provider must provide enough information about the procedure for the patient to use the telephone number or website of the health plan to calculate out-of-pocket expenses if the patient requests.  A health care provider who refers a patient to another provider that is part of the same provider organization must disclose this fact to the patient.


Current as of June 2015