Your right to a Good Faith Estimate

In January of 2022 a new law went into effect which provides balance-billing* protections for individuals seeking care from providers or facilities who are either out-of-network for the client’s insurance plan or who do not currently have insurance coverage. This law is known as the No Surprises Act. It states that individuals as listed above are entitled to be notified of their rights when considering whether to engage the services of a provider or facility who unbeknownst to them, may not be in-network with their insurance plan. 

Client Rights:

• You have the right to receive a Good Faith Estimate of costs associated with receiving care at my office.I will provide this upon request by phone as well as in email along with your appointment confirmation. Receipt of the Good Faith Estimate does not constitute an agreement by you to receive services at my office.

• If I am an out-of-network with your insurance plan, you have the right to pursue care with other providers and agencies which may be in-network with your insurance plan.

• You have the right to dispute any fees which are incurred and appear to be above what is listed in the Good Faith Estimate Provided to you in writing and/or on my website or listed on a directory I prescribed to and hold license of as well.

• You may wish to receive care with me as your provider even though I am out-of-network with your insurance plan. In this case, I will require a signed consent in your intake form in order to bill at the rates listed on our Good Faith Estimate and to bill for any balances due above out of network rates.

• I endeavor to regularly update directories and our website to reflect accurate insurance plan participation.