The No Surprise Act was passed in December 2020, under Section 2799B-6 of the Public Health Service Act, with the aim of protecting consumers from receiving unexpected medical bills. It went into effect 1 January 2022.

The Good Faith Estimate provision of the No Surprises Act federally mandates that healthcare providers give clients who do not have insurance or who are not using insurance an estimate of the bill for their healthcare services.

What is a Good Faith Estimate?

A Good Faith Estimate is an estimate of the total expected costs of non-emergency healthcare items or services.

ThriveOne provides Good Faith Estimates that project 12 months in advance. Basically, your estimate will give you a reasonable idea of what to expect in terms of therapy/service costs for one year, based on current rates and session frequency. 

What are your rights as a client?

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare service or items.

  • You have the right to receive your Good Faith Estimate in writing at least 1 business day before your scheduled healthcare service or item. If a service is scheduled at least 10 business days in advance, the Good Faith Estimate must be provided within 3 business days (of the scheduling, not of the appointment itself). If a service is scheduled at least 3 business days in advance, the Good Faith Estimate must be provided within 1 business day of scheduling. 

  • You have the right to request a Good Faith Estimate before you schedule a healthcare service or item. For services scheduled less than 3 business days in advance, please note that a Good Faith Estimate is not required by federal law and will not be provided for you in written form except by request.

  • You have the right to receive a requested Good Faith Estimate within 3 business days.

  • You have the right to dispute or appeal a bill that is at least $400 more than your Good Faith Estimate.

    • You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You may ask them to update the bill to match the Good Faith Estimate, negotiate the bill, or ask if financial assistance is available.

    • You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about four months) of the date on the original bill.

    • There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this GFE. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

Disclaimers

  • The information provided in the Good Faith Estimate is only that: an estimate.

  • The Good Faith Estimate is not a contract, and does not bind, obligate, or require any client to obtain healthcare services or items from the provider at any time.

  • The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. Additional charges may be incurred if complications or exceptional circumstances occur.

  • There are no federal provisions allowing clients to waive their right to a Good Faith Estimate at this time. Clients are required to acknowledge receipt and understanding of each new Good Faith Estimate in order to comply with federal law and continue with the provider.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Make sure to save a copy or picture of your Good Faith Estimate.

The No Surprises Act & Good Faith Estimate Notice