No Surprises Act
As of January 1, 2022, the No Surprises Act took effect nationwide, which seeks to protect people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. Additionally, the No Surprises Act provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider. As such, this allows for people to ask providers for an estimated cost of services, referred to as a Good Faith Estimate.
The Good Faith Estimate
Under the No Surprises Act of 2022, people can obtain transparency of costs related to services. This can allow for opportunities for informed consent to participate in a service, as well as to advocate for oneself when needed related to medical costs.
(Please see Client Responsibility down below)
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate for a service event, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
In an effort to provide clients with a clear expectation of cost of services, it is important that you know your plan details. If you are paying out of pocket, this can be a fairly easy estimate, especially since the cost of services can be found on this site and I'd be happy to provide a copy in a quote.
However, if you are using insurance, I ask that you are aware of whether or not your plan has a deductible. This can change what the quote will reflect based on contracted insurance rates. Please have this information available before calling to coordinate services so that we can avoid those unwanted financial "surprises."
Would you like to know more?
Please click on the following link to obtain more information regarding the No Surprises Act and what a Good Faith Estimate could mean for you: