What Is the No Surprises Act?
As a mental health care provider, you want the best for your patients. Certainly, it is no one’s intention to trick their clients into paying more for services, especially since surprise bills could very well reverse the progress you’ve been making on your patients’ mental health.
However, it can be difficult to accurately estimate service costs during the initial consultation process, and without a trusted team of mental health billing experts, the murky waters of insurance are even murkier. Herein lies the reason for the No Surprises Act to be created in the first place: surprise bills are a widespread problem in need of rectification.
Surprise medical billing has been a dire issue in the United States over the last few decades. In fact, according to the ASPE, research over the last ten years shows that more than half of U.S. consumers report having received an unexpectedly large bill.
In response to this alarming trend, the No Surprises Act was signed into law as part of the Consolidated Appropriations Act of 2021, in an effort to minimize surprise medical bills.
This is good news for patients, but a bit nerve-racking for providers, as the list of rules seems to be ever-changing, yet already in effect.
What Is a Good Faith Estimate?
In accordance with the NSA, providers must give their clients a Good Faith Estimate, which is your best guess at what their total costs will be, including the expected frequency and length of treatment. The estimate must be kept separate from other forms and not incorporated or attached to other documents or packets. To get started, here is a Good Faith Estimate template provided by CMS (Centers for Medicare & Medicaid Services).
Originally passed in December of 2020, the NSA took effect on January 1, 2022. However, it seemed to sneak up on many providers, many hearing about it for the first time after its implementation. Ironically enough, this is likely how our patients have often felt when surprise bills hit their mailbox. It’s almost like an eerie game of hide-and-seek: “Ready or not, here I come!”
Rest assured, if you find yourself feeling anxious and ready to get your estimate process in order, Anchor Point Billing Solutions has your back.
No Surprises Act – FAQ
Let’s start with the basics.
1. Does the No Surprises Act Apply to My Practice?
The No Surprises Act applies to all psychologists, including private practice and internal staff at facilities.
2. When Will the No Surprises Act Take Effect?
The Act is already in effect, as of January 1, 2022. Unfortunately, a grace period is not being offered.
3. Where Do I Start?
- First, review the terms given by CMS.
- Seek further guidance from APA (American Psychological Association):
- Overall info about the No Surprises Act.
- How to provide estimates for your services.
- FAQs on the No Surprises Act and Good Faith Estimates.
- No Surprises Act Toolkit for Physicians.
- Communicate with your patients.
- Get the word out to all of your patients at once:
- Notifications about the No Surprises Act should be posted both on your website and physically in your office.
- Keep the document at one page, written in a clear, concise, and accessible manner, with large, easy-to-read font.
- Additionally, it is recommended that you send out notices via email or through the post office. Here is a template you can use to get started.
- Speak to each patient individually. Follow this guidance from the AMA on creating Good Faith Estimates.
- Get the word out to all of your patients at once:
4. What Types of Patient Payments Are Affected by the No Surprises Act?
When beginning the conversation of payment, always ask your patient, “Do you intend to use your insurance?” This simple question starts you on the right footing and gets the ball rolling to begin meeting the requirements of the No Surprises Act.
Keep in mind, the NSA applies to:
- Self-pay patients.
- Patients who are choosing not to use their insurance.
- Patients for whom you are an out-of-network provider.
5. What Happens If I Don’t Comply with the No Surprises Act?
The NSA is a work in progress, and, therefore, the full terms of enforcement are not crystal clear at this time. However, we do know that if the actual costs exceed that of your Good Faith Estimate by $400 or more, a reconciliation process is likely to occur.
Furthermore, if nothing else, it’s a matter of ethics and being as transparent as possible with your patients. If your licensure board catches wind of noncompliance, they will likely take action.
Therefore, we recommend doing everything in your power to comply with the NSA.
Feeling Stressed? Let Anchor Point Billing Solutions Ease Your Worries
It can be difficult to keep up with ever-changing rules and regulations on top of your already busy schedule. Dealing with paperwork and billing can feel like a major headache when all you want to do is focus on your clients. We understand!
At Anchor Point Billing Solutions, we’re a team of psychologists and mental health billing experts working exclusively with psychologists, therapists, and social workers nationwide to help increase revenue by streamlining your mental health billing processes.
Reach out to us regarding the No Surprises Act or if you have any other mental health billing questions; we’ll get back to you promptly! We are here to help you get back to focusing on your passion: caring for your clients.