In compliance with the No Surprises Act,  which has been effective since January 1, 2022, healthcare providers are required to notify clients of their federal rights and protections against unexpected charges related to medical or mental health care, aka “surprise billing." 

The No Surprises Act requires that we inform clients who are either uninsured or who do not intend to submit claims to their insurance for partial reimbursement of their federally protected rights to receive a notification when services are rendered by an out-of-network or private pay provider. This policy, and the subsequent receipt of a Good Faith Estimate (GFE) of the cost of services, does not apply to clients who opt to receive superbills for out-of-network insurance reimbursement.

If you qualify, you will receive a Good Faith Estimate from your provider, which will capture the service and rate tier selected upon completion of your service inquiry, no later than 1-3 business days after your first appointment. A Good Faith Estimate shows the costs of items and services that are reasonably expected for a Client’s healthcare needs for an item or service. The estimate is based on information known at the time the estimate was created and does not include any unknown or unexpected costs that may arise during treatment. Major changes will require a new GFE to be calculated and signed.

Wingspan Care, PLLC does not participate with any insurance plan; therefore, we are considered an out-of-network or private pay provider. This means that our clients must pay us directly for services rendered. The Good Faith Estimate is not a contract between the provider and the client and does not obligate or require the client to obtain any of the listed services from the provider.

In accordance with the No Surprises Act, if you receive a bill for services that is at least $400 more than your Good Faith Estimate you can dispute the bill. For questions or more information about your right to a Good Faith Estimate or the dispute process, or to get a form to start the process, go to www.cms.gov/nosurprises or call HHS at (800) 985-3059. Clients should also maintain a copy of their GFE in their records.