Good Faith Estimates and the No Surprises Act – Effective January 1, 2022
(a copy of this notice is also available in our office)
As of January 1, 2022, all health care providers are required to provide a good faith estimate to any person who is receiving services, and who is not using insurance or doesn’t have insurance for those services.
Important Points of This Law and How it Affects You When Working With a Counselor at Evolve Counseling.
The No Surprises Act was created to avoid consumers receiving a “surprise” bill from an out-of-network provider when they thought the services they were receiving would be covered by their in-network insurance benefits. It is intended to make it easier to understand all that you will be billed.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
At Evolve Counseling:
The way services work at Evolve Counseling, all fees are understood at the time you start working with your counselor. They are included in the Consent and Disclosure document that you review and sign. You only pay for one session at a time and are not committed to pay for your next session until the cancellation window is reached (24 hours before it is scheduled), and you are not committed to attending or paying for any other sessions after that.
At times you may be referred to services outside of Evolve Counseling. You are not obligated to see a provider we refer you to.
In the Good Faith Estimate, we will now be providing you with, we are expected to include a diagnosis, the services we recommend, the frequency of those services, and an estimate of the total cost.
It is important for you to know that this is a little difficult in mental health for many reasons, including the following:
- It can take some time to fully understand the appropriate diagnosis for a person;
- Sometimes people choose to work with a counselor when there isn’t an appropriate diagnosis at all;
- Every person approaches personal work in their own unique way and while it can take one person a very short time to reach their goal, it may take another a much longer time.
Because of this, and if you choose to go work with Evolve Counseling and you either choose not to use insurance or we do not accept your insurance, the good faith estimate for your initial session will be the cost of that session only (you will be informed about the fee).
Once we meet, I will understand more about you and your situation and will be able to provide an updated good faith estimate.
Your good faith estimate can be reviewed at any time upon your request, and I may also initiate a review of your estimate if necessary. This estimate could go up or down as a result of many factors including your life circumstances changing, how quickly you are making progress towards your counseling goals, additional information about your mental health becoming better understood as a result of your counseling work, or as a part of reviewing your counseling goals.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the Colorado Division of Insurance at 303-894-7490 or 1-800-930-3745.
– This notice is effective January 1, 2022
Please contact Kelly Cote, LPC, LAC at kelly@evolvecounselingco.com for more information