GREENWOOD VILLAGE, Colo. (KDVR) — Anita Gulati didn’t even know about the No Surprises Act when she contacted the Problem Solvers about a $739 medical bill that was definitely surprising.

The Greenwood Village mother had taken her son, Cyrus, to the emergency room at Sky Ridge Medical Center in Lone Tree on June 15.

“Feeling like sharp abdominal pain in my lower abs, and it was pretty painful. And it’s like it was going on for like three or four days,” Cyrus Gulati said.

The 19-year-old remembered being evaluated by a surgeon at the hospital and remembered how brief the visit was.

“He just felt around my stomach and said, ‘You’re good,’ and walked away. And I was, ‘Huh, sweet,'” he said.

What wasn’t so sweet was the $739 medical bill from the surgeon after his parent’s insurance, UnitedHealthcare, paid the in-network hospital.

“‘You are responsible for this, and it’s going to go to collections if you don’t pay,'” is what Anita remembers being told by the doctor’s billing office.

Why such a big bill at an in-network hospital?

The reason was that the surgeon, who evaluated Cyrus and confirmed no surgery was needed, was an out-of-network doctor who had privileges to practice at the Gulatis’ in-network hospital.

“No mother should have to worry about going to an emergency department that they chose, that’s in-network, worrying if their child can be seen by certain doctors and asking people who come into the room to provide services for your child, ‘Are you in-network or are you out of network?'” Anita said.

Lawmakers agree, which is why both Colorado and the federal government each passed versions of the No Surprises Act, which took effect on Jan. 1, 2022, six months after Cyrus Gulati visited Sky Ridge Medical Center. The new law is supposed to outlaw balanced billing, the practice of out-of-network doctors billing an extra amount for what most patients would assume was an in-network visit.

Anita Gulati said she spent hours upon hours on the phone demanding answers for eight months until she finally reached out to the Problem Solvers for help.

“I can’t get straight answers from anyone,” she said.

How the No Surprises Law takes effect

While the billing office for the surgeon never returned multiple calls from the Problem Solvers, FOX31 was able to learn why the Gulatis received a bill that, on the surface, seemed to violate the new law.

The No Surprises Act takes effect when an insurance plan comes up for its annual renewal, and for most employers, that tends to be in January.

But the Gulatis’ employer didn’t renew its health insurance plan until November 2022, five months after Cyrus was treated, which means his medical visit wasn’t protected by the No Surprises Act.

While the billing office may have violated the spirit of the new law, it did not violate the fine print of the law when it sent the Gulatis the $739 bill.

But after the Problem Solvers asked UnitedHealthcare to contact the provider, the doctor did finally agree to waive the bill.

In an email, UnitedHealthcare told FOX31, “We were pleased to help resolve this issue and glad that Cyrus is no longer responsible for the doctor’s bill.”

Cyrus Gulati told the Problem Solvers dealing with medical bills is one part of adulthood he’s not looking forward to.

“I’m scared to go to the hospital and have to deal with all this, and that shouldn’t be the case. You should be able to go to a hospital, get treatment and be OK with the bill and everything and it gets covered.”