Notice: “No Surprises Act” & Good Faith Estimate (GFE)
Dear Current And Potential Future Clients,
Apparently Congress enacted a “No Surprises Act” which is set to go into effect 1/1/2022. The act is described as “new federal protections against surprise medical bills that take effect in 2022. Surprise medical bills arise when insured consumers inadvertently receive care from out-of-network hospitals, doctors, or other providers they did not choose” (please see https://www.kff.org/health-reform/issue-brief/no-surprises-act-implementation-what-to-expect-in-2022/).
It is highly unlikely this could affect our work together. There will be no situation in which you would “inadvertently” receive care from me or with no choice. Also, the final rules about how to implement this in a practice such as mine have not even been written yet by the federal government.
If we currently work together, you are already aware of my charges and your costs. If you are considering working with me, available information suggests I might need to provide you with a diagnosis before we even meet, which of course would be both unethical and impossible without a meaningful evaluation of your circumstances. At this time, multiple professional organizations are scrambling to understand the details of this law, to whom it applies and how to apply it. Guidance so far is uncertain and in many cases conflicting.
Rest assured that I will be as transparent with you about the costs of the services we agree on together. You will have “no surprises” here. This transparency is required by ethical standards by which I have abided for all the years I have been in practice, and simply because it is necessary for us to work well together.
In the meantime, you may certainly ask me about any costs about which you may be unsure, and you will be provided clear information about how I structure fees in my practice.
Please feel free to contact me if you have any related questions, and be sure to read the information below.
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 health care 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.
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 the Colorado Division of Insurance at 303-894-7490 or 1-800-930-3745.