No Surprises Act

A federal that law that went into effect on January 1, 2022, the No Surprises Act aims to curtail surprise billing and protect consumers when obtaining medical care, which includes services provided by therapists to patients. The law is to protect consumers from excessive out-of-pocket costs. Under this law, health care providers are required to provide patients who do not have insurance or who will not be using their health insurance an estimate for health services. This estimate is known as a Good Faith Estimate.

A Good Faith Estimate shows the costs of items or services that are reasonably expected for your health care needs. The estimate does not include any unexpected costs that may arise during treatment. While you could be charged more for unforeseen complications, federal law allows you to dispute the bill.

Patients have the right to receive a Good Faith Estimate for the total expected cost of non-emergency services. Health care providers are expected to provide a Good Faith Estimate at least 1 business day before your medical service. You may also ask your health care provider for a Good Faith Estimate before you schedule service. Should you receive a bill that is $400 or more than your Good Faith Estimate, you are allowed to dispute the bill.

You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will pay the price on the Good Faith Estimate you received. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

To learn more and get a form to start the process, go to https://www.cms.gov/nosurprises or call No Surprises Help Desk at 1-800-985-3059.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit https://www.cms.gov/nosurprises or call No Surprises Help Desk at 1-800-985-3059.

At DC CBT, we will ask if you will be using your health insurance before making your appointment. If you inform us that you do not have health insurance or will not be using your health insurance, we will provide you with a Good Faith Estimate before you begin services at DC CBT. You will periodically receive updated estimates during the course of services. We recommend that you save a copy or a picture of your Good Faith Estimate. If you have questions, please contact DC CBT at 202-888-9183.