Key Facts: California Medical Billing Protections
Dispute Window
180 days from Explanation of Benefits (EOB) for insurance appeals
Applicable Statute
Consumer Protections
California has robust consumer protections including AB 72 surprise billing law and an independent medical review process
Surprise Billing Protection
Yes — state-level surprise billing law
Balance Billing Restrictions
Yes — state restrictions on balance billing
Key Consumer Protections in California
- California's AB 72 (2017) prohibits balance billing for non-emergency services at in-network facilities by out-of-network providers.
- Patients can request an Independent Medical Review (IMR) through the DMHC for denied claims.
- The federal No Surprises Act provides additional protections for emergency and air ambulance services.
- Healthcare providers must provide a written estimate for services expected to cost over $400.
- Patients have the right to request an itemized bill and dispute any charges they believe are incorrect.
- Consumers can file complaints with the California Department of Managed Health Care (DMHC) or Department of Insurance.
Read the full statute: Cal. Health & Safety Code § 1386.1; AB 72
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Disclaimer: This information is for general informational purposes only and does not constitute legal or professional advice. Laws and regulations may change. Consult a licensed attorney or certified medical billing advocate for advice specific to your situation.
Content last reviewed: March 2026.