2 anesthesiology; (C) laboratory and pathology services; (D) radiology; (E) neonatology; (F) diagnostic services; (G) assistant surgeons; (H) Hospitalists; (I) Intensivists; and (J) any services set out by the U.S. Department of Health & Human Services. Non-Participating Providers satisfy the notice and consent requirement as follows: 1. By obtaining your written consent not later than 72 hours prior to the delivery of services; or 2. If the notice and consent is given on the date of the service, if you make an appointment within 72 hours of the services being delivered. Non-Participating Air Ambulance Services When you receive Covered Services from a Non-Participating Air Ambulance Provider, your Out-of- Pocket costs will be limited to amounts that would apply if the Covered Service had been furnished by a Participating Air Ambulance Provider. How Cost-Shares Are Calculated Your cost shares for Surprise Billing Claims will be calculated based on the Recognized Amount. Any Out-of-Pocket cost shares you pay to a Non-Participating Provider for either Emergency Services or for Covered Services provided by a Non-Participating Provider at a Participating Facility or for Covered Services provided by a Non-Participating Air Ambulance Service Provider will be applied to your Participating Out-of-Pocket Limit. Appeals If you receive Emergency Services from a Non-Participating Provider, Covered Services from a Non- Participating Provider at a Participating Facility, or Non-Participating Air Ambulance Services and believe those services are covered by the No Surprise Act, you have the right to appeal that claim. If your appeal of a Surprise Billing Claim is denied, then you have a right to appeal the adverse decision to an Independent Review Organization as set out in the “Grievance and External Review Procedures” section of this Benefit Book. Provider Directories Anthem is required to confirm the list of Participating Providers in its Provider Directory every 90 days. If you can show that you received inaccurate information from Anthem that a Provider was Participating on a particular claim, then you will only be liable for Participating cost shares (i.e., Copayments, Deductibles, and/or Coinsurance) for that claim. Your Participating cost-shares will be calculated based upon the Maximum Allowed Amount. Transparency Requirements Anthem provides the following information on its website (i.e., www.anthem.com): Protections with respect to Surprise Billing Claims by Providers, including information on how to contact state and federal agencies if you believe a Provider has violated the No Surprises Act. You may also obtain the following information on Anthem’s website or by calling Member Services at the phone number on the back of your ID card: • Cost sharing information for covered items, services, and drugs , as required by the Centers for Medicare & Medicaid Services (CMS); and • A listing / directory of all Participating Providers.