NO SURPRISES ACT

Right to Receive a “Good Faith Estimate” of Expected Charges Under the No Surprises Act

You have the right to receive a “Good Faith Estimate” that explains how much your medical care will cost.

Under the law, health care providers must give patients who do not have insurance, who choose to not use insurance, or who use out-of-network insurance benefits an estimate of the bill for their 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 such as medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least one (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 may dispute that 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 contact our office.

Lifespan Psychological Services
5250 Cherokee Avenue, Suite 411
Alexandria, VA 22312

Phone: (703) 596-9476
https://lifespanpsyc.com