Right to receive a Good Faith Estimate of expected charges under the No Surprises Act
Beginning January 1, 2022, federal laws regulating healthcare have been updated to include the “No Surprises” Act. This Act requires healthcare providers to provide current and new clients a “Good Faith Estimate” (GFE) on the cost of treatment.
This new regulation is designed to provide transparency to patients regarding their expected medical expenses and to protect them from surprises when they receive their medical bills. It allows patients to understand how much their health care will cost before they receive services.
For counseling in particular, several factors make It challenging to predict exactly how many appointments it will take for a client to complete treatment, and much depends on the individual client’s goals for seeking therapy in the first place. Some clients are satisfied with a partial reduction in symptoms while others continue longer because they later address a second issue, or simply feel a benefit to continuing their care. Additionally, as some clients begin finding relief they may choose to meet less frequently or to return only for occasional “tune ups,” while other clients prefer to continue counseling at the original frequency. Ultimately, as the client, it is your decision when to stop therapy.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost, since Dr. Hill has stayed independent of insurance contracting, and will not be in-network for your plan.
- 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. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule any appointments or services.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill within 120 days through the US Department of Health and Human Services. There is a $25 fee to use this dispute resolution process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the provider, you will have to pay the higher amount.
- Make sure to save a copy or picture of your Good Faith Estimate.