NO SURPRISES ACT: What is it and how does it impact my care?
Good Faith Estimate
Effective January 1, 2022, a ruling went into effect called the “No Surprises Act” which requires practitioners to provide a “Good Faith Estimate” about out-of-network care. The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for therapy. The estimate is based on information known at the time the estimate was created.
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for a service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill. You may contact the health care provider to let them know the billed charges are higher than the Good Faith Estimate.
Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers are required to inform individuals who are not enrolled in a plan or coverage or not seeking to file a claim with their plan or coverage of their ability, upon request, or at the time of scheduling services to receive a “Good Faith Estimate” of expected charges.
Note: The Public Health Service Act and Good Faith Estimate does not currently apply to any clients who are using insurance benefits, including “out of network benefits” (i.e., submitting superbills to insurance for reimbursement).
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059.
This Notice is effective on 1/1/2022.
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS (OMB Control Number: 0938-1401)