No Surprises Act

As of January 1st, 2022, the Centers for Medicare and Medicaid Services (CMS) instigated a new Federal rule, called “No Surprises Act”, to protect patients from unexpected medical bills. This rule was brought into law mainly due to patients finding themselves being billed for services that were not covered or provided by someone who was not credentialed under their insurance during emergency care visits. However, this new rule requires ALL healthcare providers, including mental health care providers, to provide notice of the new law and a “Good Faith Estimate” (GFE) to clients who do not have health insurance or are not using their health insurance, estimating the cost of services and how long services may last.

  • The Good Faith Estimate is a breakdown of the expected cost of items and services.

    • Note: The GFE does not include any unknown or unexpected costs that may arise during treatment.

  • You have the right to receive a GFE for the total expected cost of any non-emergency item or service.

  • Healthcare providers are required to provide you with a GFE before services commence. If you do not receive a GFE, you have the right to request one.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute or appeal the bill:

    • By contacting to healthcare provider or facility and asking them to amend.

    • You may start a dispute resolution process with the U.S. Department of Health and Human Services (HHS).

      • Note: you must start the dispute process within 120 calendar days of the date on the original bill

      • There is a $25 fee to use the dispute process.

  • Always keep a copy of the Good Faith Estimate. 

To learn more, go to www.cms.gov/nosurprises or call 800-985-3059. You will find answers and instruction on the dispute process here as well. 

If you have any questions regarding the No Surprise Act/GFE relating to Integrative Healing Counseling Service, PLLC, please contact Sophia Fleming LCSW at 623-277-0228 or email sophia@ihcounselingservice.com

A GFE is not a contract, it for your protection only. It does not obligate you to accept the services.