NO SURPRISES ACT
Your therapist will provide you with information on the No Surprises Act and a Good Faith Estimate at the time of your first appointment. Additional estimates are available upon request.
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
(OMB Control Number: 0938-1401)
The No Surprises Act is a federal rule, effective January 1, 2022, created to protect consumers from surprise health care bills. This Act requires medical workers, clinical social workers and other health care providers to notify consumers of their federally protected rights and to provide consumers with a good faith estimate (GFE) of expected charges that may be billed for these items or services when:
client services are rendered by an out-of-network provider
clients are uninsured (e.g., not enrolled in any health plan or coverage)
clients elect not to use their insurance (e.g., self-pay or not seeking to file a claim with their plan or coverage)
The GFE must be provided both orally and in writing, upon request or at the time of scheduling health care items and services and within specific timeframes.
This Act applies to both current and future patients who fit these guidelines.
The notifications and GFEs do not need to be provided to patients who are enrolled in federal health insurance plans (e.g., Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). The notifications and GFEs also do not yet apply to other insurance plans when a consumer or client is working with in-network providers and using in-network insurance to pay for medical services.
If you believe you’ve been wrongly billed, you may contact: Illinois Department of Insurance, Office of Consumer Health Insurance at (877) 527-9431.
Other Resources:
Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.
Visit https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=096-1523&GA=96 for more information about your rights under Illinois law.
Spoke Therapy
636 Church Street
Suite 515
Evanston, IL 60201
847-904-1220