Understanding Your Rights Under the No Surprises Act

As a client seeking mental health services, you’re protected by the No Surprises Act, which went into effect January 1, 2022. This law ensures you receive a Good Faith Estimate (GFE) of expected costs when you schedule services at least three days in advance or request one from your provider. If you’re uninsured or not using insurance for your care, your mental health provider must give you a clear estimate including details about your scheduled services and their anticipated costs. The GFE will contain information about your treatment, expected charges, and important disclaimers explaining your right to dispute any bills that exceed the estimate by $400 or more through a patient-provider dispute resolution process. This transparency helps you make informed decisions about your care without unexpected financial burdens. Your provider should make information about GFEs readily available in their office, on their website, and wherever you schedule appointments. If you have questions about this process, you can ask your provider or consult resources available through healthcare advocacy organizations.

Resources to Learn More About the No Surprises Act

Here are some helpful resources where you can learn more about your rights under the No Surprises Act and Good Faith Estimates:

1. Centers for Medicare & Medicaid Services (CMS)

   • CMS No Surprises Act Information
   • Official government website with patient resources, including the standard notice form “Right to Receive a Good Faith Estimate of Expected Charges”(aamft)

2. Consumer Financial Protection Bureau (CFPB)

   • Know Your Rights: Medical Billing
   • Information about your rights regarding medical bills and the dispute resolution process

3. American Psychological Association (APA)

   • Patient Resources on the No Surprises Act
   • Provides patient-friendly explanations of Good Faith Estimates (psychiatry)

4. Mental Health America

   • Understanding Your Mental Health Care Costs
   • Helpful information on understanding mental health care costs and insurance coverage

5. Palo Alto University Resources

   • Navigating the No Surprises Act Blog
   • Includes FAQ about what should be in a Good Faith Estimate and what to do if there are discrepancies between estimates and final bills (paloaltou)

Remember, under this law, you have the right to:

• Request a Good Faith Estimate before scheduling services
• Receive clear information about expected costs
• Dispute bills that exceed estimates by $400 or more
• Be protected from unexpected out-of-network charges in certain situations

If you have questions about your specific situation, please feel free to ask your provider for clarification about how they implement these protections in their practice.