The No Surprises Act
The No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, went into effect on January 1, 2022. This act was designed to protect clients from surprise billing and from receiving bills from out-of-network providers at in-network facilities. Designed to hold clients liable only for in-network cost-sharing amounts, the No Surprises Act also enables uninsured clients to receive a good faith estimate for the cost of their care.
Surprise billing occurs when clients receive care from out-of-network providers without their knowledge. Out-of-network providers may charge higher costs for medical services than providers who are within the individual’s health plan network. The No Surprises Act was designed to cut down on surprise costs and to ban out-of-network charges without advance notice.
Requiring out-of-network providers to provide their clients with advance notice that they are out of the client’s health plan’s network is part of the purpose of the No Surprises Act. Clients must be notified about these charges within seventy-hours of their scheduled appointment or service (or within three hours for same-day-services). Any client can waive paying out-of-network prices for non-emergency services with consent.
If Valerie Acosta, LPC, M.Ed., LLC is an out-of-network provider for you, or if you are uninsured, you will be notified according to this Act and/or provided with a good faith estimate. Please know that you are never required to give up your protections from surprise billing and you are not required to get out-of-network care. You can choose a provider or facility in your plan’s network.
There is also a requirement which states that out-of-network providers must notify health plans when they provide a client service, and they must certify that they have met the required notice and consent requirements. We will keep these records for a minimum of seven years.
If you think you have been wrongly billed or have more questions, please call (804) 396-2585. Complaints may be directed to the Centers for Medicare & Medicaid Services (CMS) at https://www.cms.gov/nosurprises/consumers or 800-985-3059.
Surprise billing occurs when clients receive care from out-of-network providers without their knowledge. Out-of-network providers may charge higher costs for medical services than providers who are within the individual’s health plan network. The No Surprises Act was designed to cut down on surprise costs and to ban out-of-network charges without advance notice.
Requiring out-of-network providers to provide their clients with advance notice that they are out of the client’s health plan’s network is part of the purpose of the No Surprises Act. Clients must be notified about these charges within seventy-hours of their scheduled appointment or service (or within three hours for same-day-services). Any client can waive paying out-of-network prices for non-emergency services with consent.
If Valerie Acosta, LPC, M.Ed., LLC is an out-of-network provider for you, or if you are uninsured, you will be notified according to this Act and/or provided with a good faith estimate. Please know that you are never required to give up your protections from surprise billing and you are not required to get out-of-network care. You can choose a provider or facility in your plan’s network.
There is also a requirement which states that out-of-network providers must notify health plans when they provide a client service, and they must certify that they have met the required notice and consent requirements. We will keep these records for a minimum of seven years.
If you think you have been wrongly billed or have more questions, please call (804) 396-2585. Complaints may be directed to the Centers for Medicare & Medicaid Services (CMS) at https://www.cms.gov/nosurprises/consumers or 800-985-3059.