The No Surprises Act
The No Surprises Act went into effect in 2022 to protect patients from unexpected medical bills and to transparently plan for and predict the cost of treatment. Under this law, healthcare providers are required to give patients who do not have health insurance or decide not to submit a superbill to their insurance for reimbursement a “Good Faith Estimate”, or GFE.
If you indicate to your provider that you are not using insurance, make sure you receive a GFE at least 1 business day prior to services. You may also request a GFE prior to deciding to begin treatment to better plan for related costs.
A GFE will include information related to anticipated treatment based on the frequency and duration discussed during the intake process as well as ongoing evaluation based on clinical needs. The following should be included in your GFE: patient-identifying information, services provided with the billing codes attached, itemized charges, diagnostic information, and provider information including where the services are expected to take place.
The GFE is only an estimate; changes can occur based on clinical needs and a provider can send you an updated GFE should costs expect to increase from the original GFE you were provided. Estimated costs on your GFE are valid for 12 months.
If a bill received is $400 more than what your GFE outlines, you are entitled to file a dispute for these charges. Learn more about eligibility and how to file a dispute here: https://www.cms.gov/medical-bill-rights/help/dispute-a-bill.
For more information or FAQs see the following resource: