No Surprises Act

Notice of No Surprises Act

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The Federal No Surprises Act went into effect on January 1, 2022 to protect patients from surprise medical bills. As a result, all licensed health providers who offer out of network services are required to post a notice of “your rights and protections against surprise medical bills” on our websites or in our physical offices.  As a completely out-of-network practice, we are transparent with our fees so our patients know and can plan for the cost of services. This transparency has been required by the ethical standards by which we have abided for the entirety of our  careers, and because we believe it is the only way for us a clinicians to bring trust and integrity into our working relationship.

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You may know that many people have been harmed by surprise medical bills, often incurred during emergency or surgical care where there may be out of network providers involved in a patient’s care without their knowledge. It is unlikely this could occur when receiving services at our center as there should be no situation in which you would “inadvertently” receive care from from one of our clinicians or receive care with no choice. Again, the nature of mental health services are different and we do not engage in surprise or balance billing. Further, in accordance with the Act, we will gladly provide a Good Faith Estimate of the costs of services prior to a first session and in the course of treatment.  Rest assured, you can always ask any of our clinicians about any costs about which you may be unsure, and you will be provided clear, accurate information.

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OVERVIEW

Surprise billing occurs when clients receive care from out-of-network providers without their knowledge. Surprise billing therefore results in higher costs for medical services that would have been cheaper if rendered by providers inside their health plan’s network. This can happen when someone involved in the client’s care is not in-network. The rule is intended to cut down on surprise costs, and also to ban out-of-network charges without notice in advance (providing clients plain-language consumer notice).

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CONSUMER NOTICE

Requiring out-of-network providers to provide any of our potential clients with notice that they are outside of the client’s health plan’s network is a large part of the No Surprises Act’s purpose. Any potential client can waive paying out-of-network prices for non-emergency services so long as they consent. We have a standard notice that can be given to out-of-network clients when they seek services, which must be given to clients within seventy-hours of the scheduled appointment or service (or within three hours for same-day-services). At your request, we will provide this notice to you in paper or electronic format, as you prefer, and you will receive a copy. The form will clearly state:

• 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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This document will be separate from all other documents you sign prior to care. We will provide it in additional languages if requested. 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.

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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 at (404) 565-4385.

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COMPLAINTS

If you still feel you have been wrongly billed, complaints may be directed to our Compliance Department at 888-513- 9976 or to the Centers for Medicare & Medicaid Services (CMS) at https://www.cms.gov/nosurprises/consumers or 800- 985-3059

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