Cultivating Hope & Strength to Improve Lives
No Surprises Act
Effective January 1, 2022, the No Surprises Act came into effect to protect clients from surprise bills for emergency services at out-of-network facilities or for out-of- network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured clients to receive a good faith estimate of the cost of care. Under federal law, health care providers are required to give patients who don’t have insurance or who are not using insurance (out of network for the client) an estimate of the bill for medical services, which includes outpatient mental health.
As a client, you have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services. Requiring out-of-network providers to provide any of our potential clients with notice that they are outside of the clients’ health plan network is a large part of the No Surprises Act’s purpose. Any potential client can decline services to avoid having to pay out- of-network prices for non-emergency services so long as they notify our office if they do not wish to seek out-of-network services.
FFC will give notice to clients through a separate email, which is sent out before a client is seeking out services, whether it’s in-network or out-of-network (out of pocket). Family Foundations Counseling, PLLC will give you a Good Faith Estimate in writing at least 1 business day before your scheduled intake session or within 3 hours for same day services. You may ask Family Foundations Counseling, PLLC for a Good Faith Estimate before scheduling an intake appointment.
The estimate for outpatient mental health benefits will clearly state:
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- The provider (or our facility) is out-of-network
- An estimate of the cost of our services (which we will calculate in good faith)
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You are never required to give up your protections from surprise billing. You also are not required to get out-of- network care. You can choose a provider or facility in your plan’s network.
Lastly, there is a requirement which states that out-of-network providers must notify health plans when they provide a client service, and they must certify that they have met the required notice and consent requirements. We will keep these records for a minimum of seven years.
If you think you have been wrongly billed or have more questions
If you think you have been wrongly billed or are uncertain whether the No Surprises Act applies to you or if you have any additional questions about standard notice forms or the No Surprises Act in general, please contact us.
Complaints
If you still feel you have been wrongly billed, complaints may be directed to our billing specialist at 253-777-3600 or to the Centers for Medicare & Medicaid Services (CMS) at https://www.cms.gov/nosurprises/consumers or 800- 985-3059.
Please save a copy of this notice and a copy of the Good Faith Estimate for your records.