Under Section 2799B-6 of the Public Health Service Act (effective as of January 2022), healthcare providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.
· You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. (To dispute your bill the process charges a $25 fee.)
Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.
Spero Counseling offers aGood Faith Estimate 12 months in advance. This 12 month time frame is due to potential session rate increases, happening on the first of each year (up to 10% of the current session fee). Your estimate gives you an idea what to expect in terms of cost annually. This estimated cost will depend on a variety of factors including current rate, frequency of session, and type of session. Your good faith estimate will include your name, date of birth, cost per session, description of services, diagnostic codes, provider name, NPI, and any other relevant data needed or requested.