No Surprises Act

Your Right to Receive a “Good Faith Estimate” of Expected Charges

Under Section 2799B-6 of the Public Health Service Act, healthcare providers and facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage, both orally and in writing, of their ability, upon request or at the time of scheduling, to receive a Good Faith Estimate of expected charges.

What the Good Faith Estimate Includes

A Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

The estimate will generally include:

• Expected charges for the primary item or service
• Expected charges for related items or services that are reasonably expected in connection with the primary service
• The name and in-network status of each provider expected to be involved in your care
• Applicable diagnosis and service codes
• The expected date the service will be provided

If Your Bill Is Higher Than the Estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

To start the dispute process:

1. Contact your provider to let them know the billed charges are higher than the Good Faith Estimate.
2. Ask them to update the bill to match the Good Faith Estimate, agree to a payment plan, or explain why the bill is higher.
3. If you and your provider cannot resolve the dispute, you may use the patient-provider dispute resolution process available under federal law.

Balance Billing Protections

Federal law generally prohibits out-of-network providers from billing you more than in-network cost-sharing for emergency services and certain other services received at in-network facilities. This is called "balance billing." The No Surprises Act provides important protections:

• Emergency services: You cannot be balance billed for emergency services, even if you get them from an out-of-network provider at an out-of-network facility.
• Non-emergency services at in-network facilities: You cannot be balance billed for non-emergency services from out-of-network providers unless you give written consent and give up your protections.
• Air ambulance services: You cannot be balance billed for air ambulance services from out-of-network providers.

Where to Get Help

To learn more about your rights under the No Surprises Act, or to submit a complaint if you have been balance billed in violation of these rights:

• Visit the Centers for Medicare & Medicaid Services (CMS) website: cms.gov/nosurprises
• Call the No Surprises Help Desk: 1-800-985-3059
• Contact your state insurance commissioner's office for additional state-level protections that may apply.

Contact Kun Hearing

If you have questions about a bill you received, would like to request a Good Faith Estimate before your visit, or have concerns about balance billing, please reach out to us directly. We are committed to transparent, honest billing.

Additional Resources

For more information about the No Surprises Act and your rights as a patient, visit:

• CMS No Surprises Act resource center
• HHS Patient Rights information