What happens to my Out-of-network child delivery bill of $38,000 after my insurance denies it, but the No Surprises Act is enforced in NJ? Is it just completely waived?

Also the “The Out-of-network Consumer Protection, Transparency, Cost Containment, and Accountability Act” may apply as well for New Jersey.

Yes, that number is correct.

So my wife gave birth 3 months ago, after an emergency room admittance when her water broke (we were told the emergency factor also plays into the No Surprises Act). We went to the appropriate hospital her gynecologist pointed us too, but she was in labor for 28 hours (2 overnights) and they switched the doctor on us the second day when they tried to induce labor again. We obviously were not concerned about how the insurance plays in, furthest thing from my mind.

The claim popped up and was denied from the get-go, it was not billed under the hospital but some obscure LLC the out of network doctor billed under. I obviously don’t need to get into the realism of paying a $38,000 c-section bill over any timeline.

I was able to hunt down the LLC in September and finally got a hold of someone, they said my insurance denied it and that nothing was mailed to me yet. So I called my insurance company over a month ago and they told me about these acts, and that I’d have some kind of claim update but naturally they did nothing and acted surprised when I called back this afternoon to check in…

Even if this is under the No Surprises Act or “The Out-of-network Consumer Protection, Transparency, Cost Containment, and Accountability Act” in NJ, something tells me this bill will not simply vanish completely and I must be on the hook for something.

What worries me is that no progress is being made and this is just hanging out there, my wife is extremely nervous too. We already have like 6 other adjacent childcare/pregnancy related bills to contend with.

What happens next?