No Surprises Act & Your Right to a Good Faith Estimate

https://www.apaservices.org/practice/legal/managed/good-faith-estimate-notice.pdf

Your Rights Under the No Surprises Act

As of January 1, 2022, the No Surprises Act protects clients from unexpected medical bills. This law ensures that if you are uninsured or choose to self-pay, you have the right to receive a Good Faith Estimate (GFE) of expected charges before you receive services.

What Is a Good Faith Estimate?

A Good Faith Estimate explains how much your healthcare services will cost. It includes:

• A breakdown of expected charges for your services

• Information on potential additional costs

• Your rights if you receive a bill higher than the estimate

Who Can Request a Good Faith Estimate?

You are eligible for a Good Faith Estimate if you:

• Do not have insurance

• Are not using insurance for services

• Are receiving services from an out-of-network provider

Your Protections Against Unexpected Costs

• You have the right to receive a written Good Faith Estimate at least one business day before your scheduled services.

• If you receive a bill that is $400 or more above your estimate, you have the right to dispute the charges.

• Good Faith Estimates are provided free of charge and do not require a commitment to treatment.

How to Request a Good Faith Estimate

To receive a Good Faith Estimate for your services at SUNRISE Therapies, contact us at:

Email: riseandshine@sunrisetherapiesinc.com

More Information

For additional details about your rights under the No Surprises Act, visit: www.cms.gov/nosurprises.