What Physical Therapists, Occupational Therapists, Speech Therapists and Chiropractors Need To Know About the Surprises Act

On January 1, 2022, the No Surprises Act took effect. Below are the 10 things that you need to know about this new law

It only applies to clinics who provide cash pay services
It only applies to patients who are uninsured or pay cash
The most relevant part of the No Surprises Act is the Good Faith Estimate section which require clinics to provide an estimate of the services patients will receive.
The clinic needs to inform the patients of the estimate upon scheduling the appointment or upon request
The estimate must be in the language the patient speaks
The estimate must be kept in the patient’s file for 6 years
If the actual charge is $400 more than the estimate, the patient can dispute the bill.
The clinic is required to provide the estimate 1-3 business days after the appointment is scheduled
The estimate should include the following information:

Patient name
Patient date of birth
Description of services
Date of scheduled service
Itemized list of services, by provider, to be furnished
Diagnosis codes
NPI
Tax ID
Clinic Name
Clinic Address
Disclaimers that say you will provide a good faith estimate upon request, instructions on how to obtain additional good faith estimates, if any items will require additional scheduling you will get a good faith estimate, that the clinic may suggestion additional services not in the good faith estimate, that the good faith estimate is just an estimate, and that they have a right to dispute the bill and how to dispute the bill. Good faith estimates are not contracts and the patient may refuse the services

If the clinic does not follow the rules, the patient can dispute the bill, avoid paying and HHS (Department of Health and Human Services) can impose penalties of up to $10,000 per violation.
The clinic must provide the estimate in writing

CMS provides a template of a Good Faith Estimate Form which you can find here.