Louisiana Balance Billing Notice

Health care services may be provided to you at a network health care facility by facility-based physicians who are not in your health plan. You may be responsible for payment of all or part of the fees for those out-of-network services, in addition to applicable amounts due for co-payments,
coinsurance, deductibles, and non-covered services. Specific information about in-network and out-of-network facility-based physicians can be found
at the website address of your health plan or by calling the customer service telephone number of your health plan.