No Surprise Act / Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act www.cms.gov/nosurprises
Under the law, health care providers must provide patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.  If you don’t have health insurance or you plan to pay for health care bills yourself, generally, health care providers and facilities must give you an estimate of expected charges when you schedule an appointment for a health care item or service, or if you ask for an estimate. This is called a “good faith estimate."   

Your Right to a Good Faith Estimate

Providers and facilities must give you the good faith estimate: 

•  After you schedule a health care item or service. If you schedule an item or service at least 3 business days before the date you’ll get the item or service, the provider must give you a good faith estimate no later than 1 business day after scheduling. If you schedule the item or service OR ask for cost information about it at least 10 business days before the date you get the item or service, the provider or facility must give you a good faith estimate no later than 3 business days after you schedule or ask for the estimate 
•  That includes a list of each item or service (with the provider or facility), and specific details, like the health care service code. 
• In a way that’s accessible to you, like in large print, Braille, audio files, or other forms of communication. 
•  Providers and facilities must also explain the good faith estimate to you over the phone or in person if you ask, then follow up with a written (paper or electronic) estimate, per your preferred form of communication. 

Keep the estimate in a safe place so you can compare it to any bills you get later. After you get a bill for the items or services, if the billed amount is $400 or more above the good faith estimate, you may be eligible to dispute the bill. 

For more information, review an example of what a good faith estimate may include (PDF) and examples of good faith estimates that do and don’t qualify for the dispute process (PDF). 

​Healthcare providers are required to provide clients who do not have insurance or who choose not to use their insurance for therapy services with an estimate of the cost of those services. The total cost for each client will vary depending upon the length of time and frequency of sessions that occur throughout the therapeutic relationship as determined by the initial assessment and continued evaluation of treatment needs and progress.  A detailed list of possible services is provided.  This estimate will be valid for the next twelve (12) months.  Should any fee changes occur, or upon your request, Jenkins Family Solution Center, PLLC will provide you with a new good faith estimate. 
​​
https://www.cms.gov/nosurprises
https://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing​
​ 

This information is for general information purposes only and does not serve as legal advice or opinion.