Under the No Surprises Act, you have the right to request a Good Faith Estimate that details the costs associated with your care. A Good Faith estimate can help you better understand your healthcare costs and empower you to make a decision that works for you.
The No Surprises Act was passed in December 2020 to protect healthcare consumers from unexpected medical bills. But what does The No Surprises Act mean for you? We’re here to help you understand your rights as a client under the newly passed law.
We’ve compiled the most frequently asked questions about the No Surprises Act and Good Faith Estimates so that you can gain clarity surrounding costs for therapy.
A Good Faith Estimate can help you better understand your healthcare costs and empower you to make a decision that works for you.
What is a Good Faith Estimate?
A Good Faith Estimate is an estimate of the total cost associated with your healthcare services. Good Faith Estimates are meant to reduce the incidence of surprise medical bills.
Good Faith Estimates include the costs associated with your regularly scheduled appointments. If you see your therapist once a week, your estimate will give you an idea of how much you’ll spend on therapy for the upcoming year.
Good Faith Estimates do NOT include costs associated with
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Cancellations
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No-shows
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Emergency sessions/crisis care
At Clarity Therapy, we offer Good Faith Estimates that project 1 year in advance. Based on the frequency of your sessions, we are able to offer an estimate for your total expected therapy costs for the year.
Keep in mind that this estimate will likely overestimate your costs since it doesn’t take into account holidays and cancellations. A Good Faith Estimate is, of course, just an estimate and not an exact amount.
Does a Good Faith Estimate apply to me?
If you see a private-pay or out-of-network provider, you are entitled to a Good Faith Estimate. The therapists here at Clarity Therapy NYC are out-of-network providers and are required to provide you with a Good Faith Estimate.
If you see a private-pay or out-of-network provider, you are entitled to a Good Faith Estimate.
How do I request a Good Faith Estimate?
If you are an existing client, your therapist will ensure that you receive a Good Faith Estimate and your receipt of your Good Faith Estimate is documented. Good Faith Estimates will be kept on file if you should ever need them.
For existing clients, once you request a Good Faith Estimate, your therapist is required to provide one within 3 business days. For new clients, we will provide you with a Good Faith Estimate as long as you schedule your appointment at least 3 days in advance.
Lastly, you do not need to use the exact phrase “Good Faith Estimate” in order to receive one. If you inquire about the cost associated with your care, we’ll automatically generate a Good Faith Estimate for you.
If you inquire about the cost associated with your care, we will automatically generate a Good Faith Estimate for you.
Am I obligated to receive the services listed out in my Good Faith Estimate?
You are under no obligation to receive the services listed out in your Good Faith Estimate. Good Faith Estimates are simply estimates, not a binding contract. Receiving a Good Faith Estimate does not require you to receive the services listed in the estimate.
Good Faith Estimates are simply a tool for you to understand your healthcare costs and make an informed decision about your care.
When can I expect to receive my Good Faith Estimate?
If… Then…
| You scheduled a session at least 10 days in advance | Your therapist must provide a good faith estimate within 3 days of scheduling |
| You scheduled a session at least 3 days in advance | Your therapist must provide a good faith estimate within 1 day of scheduling |
| You scheduled a session less than 3 days in advance | Your therapist is not required to provide a good faith estimate |
| You requested a good faith estimate at any point during your care | Your therapist is required to provide a good faith estimate within 3 days |
Can I waive my right to a Good Faith Estimate?
At this point in time, there is no way to waive your right to a Good Faith Estimate. All new and existing clients will be given Good Faith Estimates.
What happens if my Good Faith Estimate ends up being wrong?
Under the No Surprises Act, you can dispute your bill if the cost of your healthcare services exceeds your Good Faith Estimate by at least $400.
You can start the dispute resolution process here. An independent, third-party will then review your claim and determine an appropriate payment. You must pay a $25 fee in order to start this process.
How will Good Faith Estimates be delivered?
Under the law, Good Faith Estimates must be distributed either on paper or in a printable format if it’s delivered electronically.
Additional Questions about Good Faith Estimates
Our therapists at Clarity Therapy NYC are more than happy to answer any questions and concerns you may have about the cost of your care. We want to make sure you have all the information you need in order to make an informed decision.
If your concerns about cost are preventing you from seeking help, we hope to provide you with the clarity you need. Schedule a free consultation today to learn more and receive a Good Faith Estimate.
If concerns around cost are preventing you from seeking help, reach out today.
Your Turn: Have questions about how to receive a Good Faith Estimate from your therapist? Share below or contact us at [email protected] for more guidance.
