No Surprises Act Overview
The No Surprises Act, which is part of the Consolidated Appropriations Act of 2021, is designed to protect clients from receiving unexpected medical bills. The Good Faith Estimate provision of the No Surprises Act is designed to give clients an estimate of how much they’ll be charged for the healthcare services they’ll be receiving, prior to their appointment.
Requirements for Providers
As of January 1, 2022, this new legislation applies to all healthcare providers and facilities operating under the scope of a state-issued license or certification. You’re required to share a specific consent document in addition to a Good Faith Billing Estimate, prior to beginning care.
State-licensed or certified healthcare providers are required to provide a Good Faith Estimate of charges to every new and continuing client who’s either uninsured or isn’t planning to submit a claim to their insurance for the services they’re seeking. You’re also required to inform every uninsured or self-pay client of their right to receive a Good Faith Estimate.
We recommend asking each client whether they have insurance and intend to use it to cover the services that they seek. If the answer to either question is no, they’ll need a Good Faith Estimate prior to their appointment.
Providers are also required to highlight the No Surprises Act on their Professional Website. A link to more information about the No Surprises Act must be present, along with a statement informing clients that they’re entitled to a Good Faith Estimate.