No Surprises Act

This page explains your rights and protections against surprise medical bills.

(OMB Control Number: 0938-1401)

When you see a health care provider, you may be responsible for certain out-of-pocket expenses such as co-pays, deductibles, or other costs associated with providers that are not in-network with your insurance. “Out-of-network” describes providers and facilities that have not signed a contract with your insurance carrier, which means that your insurance may not be accepted by those providers/facilities. Out-of-network providers may be permitted to bill you for balances or charges that are not covered by your insurance. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit. “Surprise billing” is when you receive an unexpected balance bill. This may happen when you do not have the ability to control who is involved in your care, such as when you are seen for an emergency health issue or are seen by an out-of-network provider. There may be times that you go to receive care from an in-network facility, but are seen by an out-of-network provider. The No Surprises Act protects patients and requires that out-of-network providers obtain informed consent before treating and billing the patient.

Under the law, patients that don’t have insurance or are not using insurance are to be given an estimate of the expected charges for medical services, including psychotherapy services. All health providers, including mental health providers, must give each patient a “Good Faith Estimate”, which explains how much your mental health care will cost. Before starting treatment, I will provide you with a “Good Faith Estimate” which will outline the costs of treatment.

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.

If you believe you’ve been wrongly billed, you may contact:  https://www.colorado.gov/pacific/dora/DPO_File_Complaint.

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.

Visit https://dora.colorado.gov/for more information about your rights under Colorado law.

IMPORTANT NOTE:  I am required by this act to post this information. Prior to starting therapy with me, I will provide you with a fee schedule listing the charges for my services for clients who are choosing private pay. As a therapist, it is impossible for me to predict how many sessions a particular client will need in order to achieve the client’s therapeutic goals and the overall cost of a client’s therapy. There are just too many unknowns to determine with any confidence or accuracy the cost of therapy. However, know that I will always be open with my clients when it comes to any fees for services and I will talk about a client’s treatment plan and changes to that treatment plan and how this affects continued therapy.