disclosure notice

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NO SURPRISES ACT

You have the right to know your costs to treatment.

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

Under the No Surprises Act implemented in January of 2022, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for therapy and psychiatry services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including therapy and psychiatry services. You can ask your provider for a Good Faith Estimate before you schedule a service, or at any time during treatment.

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 of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, visit www.cms.gov/nosurprises or call Regroup Counseling and Consulting PSC 763-350-9687