Frequently asked questions for providers about the No Surprises Rules – Part 1

April 6, 2022 The Consolidated Appropriations Act of 2021 established several new requirements to protect consumers from surprise medical bills. These requirements are collectively referred to as “No Surprises” rules. These requirements generally apply to items and services provided to consumers enrolled in group health plans, group or individual health insurance coverage, and Federal Employees […]
FAQS about Consolidated Appropriations Act, 2021 implementation – Good Faith Estimates (GFE) for uninsured (or self-pay) individuals – Part 2

April 5, 2022 Set out below are Frequently Asked Questions (FAQs) regarding implementation of Section 112 of Title I (the No Surprises Act (NSA)) of Division BB of the Consolidated Appropriations Act, 2021 (CAA 2021), and implementing regulations published in the Federal Register on October 7, 2021 as part of interim final rules with comment […]
Founder/CEO, Jonathan Kaplan and US Senator Bill Cassidy pen op-ed in Newsweek

The No Surprises Act, a bipartisan effort to reduce the number of surprise medical bills, went into effect on January 1. As significant as this legislation is—surprise bills are one of the biggest drivers of medical bankruptcy in America—the act is still being overlooked. This legislation remains unfamiliar to those it affects most, specifically […]
Pick your poison! Two No Surprises Act webinars to choose from

WEBINAR 1: The No Surprises Act and how it applies to ALL plastic surgeons March 9th, 4pm EST/3pm CST/2pm MST/1pm PST Joint webinar with the American Society of Aesthetic Plastic Surgery (ASAPS) If you miss the live webinar, you can still click here to watch the recording. WEBINAR 2: The No […]
Standard Notice Regarding Patient Protections Against Surprise Billing

PDF of Disclosure Notice Regarding Patient Protections Against Surprise Billing posting Must be posted in office/facility where scheduling occurs and on website
Standard Notice of Right to Receive a Good Faith Estimate

PDF of Right to Receive a Good Faith Estimate of Expected Charges Notice posting Must be posted in office/facility where scheduling occurs and on website
Estimate and consent for out-of-network (OON) billing in non-emergency situations

Example of OON consent and estimate provided by the Center for Medicare and Medicaid Services: Example of OON consent and estimate automatically created by BuildMyHealth:
Good Faith Estimate Template for uninsured, self-pay and possibly aesthetic procedures

Example of Good Faith Estimate (GFE) from the Centers for Medicare and Medicaid Services (CMS): Example of automated estimate created by BuildMyHealth platform:
Does the No Surprises Act apply to aesthetic services?

In a chat thread with colleagues on our mutual trade organizations’ message board, there was a question about providing Good Faith Estimates (GFE) for aesthetic procedures under the No Surprises Act. I stated that I didn’t think GFEs were required for aesthetic procedures but a representative from the American Society of Plastic Surgeons (ASPS) commented […]
An easy way to create a Good Faith Estimate and comply with the No Surprises Act

The No Surprises Act is officially here. It went into effect on January 1st, 2022. Yes, it’s another layer of regulatory legislation that you, the provider, are required to follow. Yes, it outlaws out-of-network balance billing in all emergency situations and many non-emergency situations. But that may not be the biggest issue for most providers. […]