How the No Surprises Act Impacts your Practice | Good Faith Estimate
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- Опубликовано: 16 июн 2024
- How the No Surprises Act Impacts your Practice | Good Faith Estimate
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Ready for a deep dive? Check out Ken Clark's Webinar on the No Surprises Act:
www.semiprivatepractice.com/a...
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UPDATED 2-14-22: Kate & Katie of The Private Practice Startup put together a FREE bundle of templates and educational information about the No Surprises Act. I've used it myself and it's super helpful! Here is a link:
www.privatepracticestartup.co...
FREE Guide: Start a Private Practice in Counseling:
tinyurl.com/y9ek9en8
The No Surprises Act seemed to appear out of nowhere and it can be a little fuzzy trying to understand when and how we're expected to offer a Good Faith Estimate to our clients.
In this video, I give an overview of the No Surprises Act and I teach you the details of how to go about implementing it properly in your private practice, including when and how to complete a Good Faith Estimate.
Links to the sources/references from the video:
CMS Good Faith Estimate Template:
www.cms.gov/files/document/go...
CAMFT Sample Good Faith Estimate Notice (post to your website and in your office):
www.camft.org/Portals/0/Docs/...
CMS Website on the No Surprises Act:
www.cms.gov/nosurprises
ASPE Article: "Evidence on Surprise Billing: Protecting Consumers with the No Surprises Act"
aspe.hhs.gov/sites/default/fi...
APA Article: "New billing disclosure requirements take effect in 2022"
www.apaservices.org/practice/...
AMA Article: "Implementation of the No Surprises Act"
www.ama-assn.org/delivering-c...
CAMFT Article: "The No Surprises Act : What MFTs Need to Know"
www.camft.org/Resources/Legal...
LINKS
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This video is geared for therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.
Welcome to Private Practice Skills! I’m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don’t have to.
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This video is not intended as professional or legal advice. Be sure to seek the services of a professional if you are in need of them.
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There is a petition going round to ask for this act to be modified for small business practitioners..... we will see what happens. In the mean time, better safe than sorry.
I’m definitely “feeling some feelings” about this. I completely understand not taking advantage of people and blindsiding them with “surprise” bills, but this feels like just one more thing to make our already time-consuming and complicated jobs even more time-consuming and complicated.
Agreed, and still not putting any responsibility on insurance companies it seems.
Exactly. You want to know why health care and insurance costs so much? Because the government can't leave it alone and stop screwing around with it.
And then when their "act", whether this one or another, goes wrong, they blame "Big Insurance" or some other mysterious villain.
What those politicians should say is --- "Well, we keep over-regulating free markets to where they aren't free markets anymore, so most of these problems can't self-resolve through competition and consumer preference. So we caused this problem and so many others."
But why would we expect politicians to be honest LOL.....
@@williegates627 I have the complete opposite view. It's the greed of corporations, with their bonuses for execs and years-long refusal to raise rates for mental health providers that has driven health care costs through the roof, not the government. We've had "free-market" healthcare for decades and decades now, and this is where we are. As an example, insulin prices have tripled over the past decade, driven by unregulated pharmaceutical companies.
Thanks for the info! The Modern Therapist Survival Guide Podcast did a really great, in-depth analysis of the No Surprises Act as well for anyone interested in getting more information regarding requirements of diagnosis
Wow! This seems overly complicated! I never heard of this and I am grateful to you for doing all this research for us! Thank you!!
Marie, thank you so much for this video! As annoyed as I am about having to implement this for my self pay private practice (I share all of your same feelings!), I’m glad you are always there to save the day with great videos offering support and explanations. You are truly gifted at what you do, please never stop Private Practice Skills!
I was officially SURPRISED 😯 by the "No Surprises Act." Maybe one day we can actually just focus on client care and not paperwork. MAYBE!!!!
Unfortunately, the GFE template on CMS's website isn't fully compliant with the regulations -- some of the required language is missing (e.g. the disclaimer that the GFE is not a contract). If you use the template, make sure you add the language that's missing.
Thank you for sharing this!
@@JasmineScott930 --You're very welcome. I also hope HHS really takes time to read the public comments, and takes the constructive criticism to heart when reworking the GFE specifications for the final rule.
Thank you so much for this video! Especially the template links. In general your videos have been so helpful to me, more than any I have ever seen in helping me with growing my practice. :)
Thank you so much for this, I was waiting for it!
Thank you for this video Marie!
Thank you so so so much! Your videos have been so incredibly helpful!
Great guidelines to follow. Thank you.
Thank you for organizing the info for us 🙋🏽♀️🎉
Thank you for doing that research and creating this video. I agree, it’s annoying because it feels like it pushes those of us who don’t have interest in dealing with insurance in that direction with all this paperwork. Thanks again!
Extremely helpful video with included resources. THANK YOU!
Thank you so much Marie for doing this video.
Thank you for synthesizing all this information !
Happy New Year! OMG! Thank you so much for this information. I had heard of this legislation but I didn't think it would really affect us since we have to tell our clients up front anyway. I don't take insurance clients either so I STILL don't get it. Thanks so much. I'm on it!
Thank you so much for your research! I never heard of this and still feel slightly confused, but appreciate you covering this topic.
You are a gift. And I’m definitely feeling ALLLLL the feelings about this.
Someone was just asking to pick my brain on the “No Surprises” Act. I sent them this video. Thank you so much for the helpful information.👏💕
God bless you. This was so helpful. It’s been so confusing and this simplified it. Thank you so much!!!!
Marie this video rocks. Clear, helpful, vulnerable, encouraging, relatable. You tackled a tough topic with such little time on your side. Huge round of applause!
Thank you so much for posting this video and for all the additional links and templates!
where do I find all the additional links and templates? I do not see them, thanks so much
Thank you Marie!
Thank you Marie.
Umm, wow! I had no idea. Time to scramble. Thanks for posting this!
Thank you Marie for your informative video. Recently, I received a GFE of $119.00 about a month before a regular doctor visit at the Banner health clinic in Peoria, AZ. I'd been going to this clinic every 6 months for about 10 years and always paid my bill before leaving 6 MONTHS later, Banner sent me a surprise bill for $56.00, for which nobody in the company - even their office manager could explain why. I asked them if they were aware of the "No Surprises Act" to which they were all clueless. Their answer instead was to send me to a collection agency. And all over $56.00....😳
Excellent!!
Thank you!
You can potentially add as many codes as it may apply to your practice on the agreement. for example individual or couples therapy. Also, if your self-pay clients have a fixed rate per session and they pay before service is provided as well as there is a financial agreement on record you do not have to provide a good faith estimate, that is unless, they requested explicitly.
Thanks so much
It is not my cash pay clients that end up with "surprise bills". It is my "insert specific insurance company name here" that doesn't process our claims as they agreed to and refuse to pay the difference but already applied the higher amount to my client's deductible and I'm stuck charging it to my client to not get into trouble for insurance fraud. But what I hear you saying is that if they are using insurance, we don't need to do the GFE... Is that correct?
It makes me grateful that I chose to go into community health practice because I don't think I can wrap my brain around this.
Hi, Marie - Thank you so much for this video. After I watched it, I did a bunch of research (don't judge me - it's how I roll) and found that this act seems to apply to emergency services, and to hospitals and surgery centers, and the folks who work within them. If what I found is correct, psychologists who do not see crisis patients or work in hospitals or surgery centers, may not be included. If anyone in your network could confirm that (or let me know I don't research very well), that would be pretty awesome.
I was also kicking around the idea of just providing the GFE for each visit, instead of trying to guess at the length and breadth of an entire course of treatment before I even lay eyes on the potential client. What do ya think?
Very helpful
Hello. Thank you for the video. While listening to it, I wondered about those of use who have sliding scale rates through programs like Open Path Collective. We already have an agreement signed by the client. Do you have anything on the sliding scale process and NSA?
I’ll be interested to see how late cancels and no shows fit into the template for insurance clients because if they have four sessions per month and one is a no show then that estimate is way off already for clients who will only be expected to pay a $20 copay. I have a feeling this will be thrown in the trash because it just doesn’t work for us and our clients. They sign the informed consent that outlines fees and I speak with them about their benefits before session #2
Thank you for this information! So if I am in private practice and have self pay clients, they have the option to use their insurance even though I may not be accepting their insurance? They cannot pay my fees out of pocket?
3:36 --> Thank you for the info! But just a numbers check: 2,000 x 10 = 20,000. If you were expecting the bill to be a couple thousand (aka 2,000) and it was 13,000, it was 6.5 times bigger, not 10, nor "more than 10x higher". Sorry, just had to point that out.
Thanks to this..what a RIP off here
With all the secrecy involved in healthcare charges..I got a fat 1000 usd for a heart stress today which I never expected....
I'm a little confused about the estimate given. We can't always know how much we will see a client, so are we supposed to base the estimate off the assumption that we will see that client on the regularly scheduled day(s) each month for the entirety of the year?
Does this act apply to continental USA only or are US territories, such as PR, Included?
What if you don’t accept insurance? Will it always be a good faith estimate for every person?
I am having trouble editing the template to match my practice. Any suggestions?Thanks. V.
The provide a diagnosis before seeing them makes me cringe. A huge part of going into private practice is to help avoid the "have to diagnosis" situation as many clients do not necessarily have a diagnosis aside from just needing counseling or going through life transitions. I see how this can be helpful, but its a bit stressful!
The link below is to sign the petition for the amendment for private practice therapist in the new act
Hello I've tried to get the starting a practice bill several times and nothing appears in my inbox. Thanks
I can't find the template you are showing
DOES ANYONE KNOW HOW WE CAN GET A COPY OF THIS CMS POSTER?
I am shocked, lawmakers did not care about basic patient protection till 2022?
Well spoken/done - you'd be a talented actress (and fun co-worker, I'm sure).
Do we have to predict YEARLY TOTALS? Is it clear that 'annual total' is what's required?
I'm a streamliner, efficience nazi at times, and envision listing all CPT code prices and a TABLE that lets them calculate total cost for any # of sessions.
Could be incorporated into Tx contract/informed consent and on our lobby walls.
I imagine all the EHRs will start incorporating an electronic form for this, and having that sent out automated/axiomatically would be easy enough.
What a waste of paper / unnecessary death of innocent TREES! :-(
I absolutely hate the part about diagnosing. That is something that I don't believe in giving to every client in my practice just because they're receiving therapy. I wish I would have found out about this and advocated for it to be different in mental health services.
This right here! It just seems they’re trying to force a diagnosis to go on their records; that was one of the main reasons I didn’t contract with insurances in the first place.
God Bless you dr odija on RUclips keep on the good work you have been doing and thanks also for curing me off this disease you are truly a God sent towards humanity I appreciate you sir dr odija!!!!
I don't really know how to thank you Dr odija on RUclips for making me to live like my fellow mates and for curing me from diabetes.... thank you so much may God always strengthen you and your work..
Thank you Dr Marie for posting this so soon after all of us therapists were "surprised" by the "no surprises act". This was such as doozy. No emails. No calls. Just my phone blowing up with frantic texts. Like Dave in Space Odessey: "Hello, Dave. Welcome to the new 2022 legislation." ruclips.net/video/Wy4EfdnMZ5g/видео.html
Doctors that can't provide dollar amounts seem to me to not be very professional. When you have a business and you don't know what anything cost and you're willing to double dip around insurance. I have words that I was taught not to use that seem fitting however to describe that
Is this only an American issue?
Kind of seems like a wolf in sheep’s clothing. Sounds super good to be able to hold these entities (usually government funded hospitals/clinics ironically) who surprise us with giant bills responsible. However the rule is set up in a typical government way, easy to mess up on so they can fine and make more money. Frustrating. I plan on making a generic form to include with my intakes and if they don’t like that they can come tell me. 🤷🏻♂️
I would like to start off by saying that I've watched several of your videos as it pertains to private practice and starting a successful counseling business. There were alot of helpful tools and resources provided.
But as I looked deeper into your methodology and belief system I was truly alarmed. How can someone call themselves a Christian and deny God's very word related to gender identity, confusion and homosexuality. True, everyone deserves to be loved and treated with respect but as Born Again believers we are not to condone or accept sin which is direct disobedience to God. Your platform has brought you notoriety, financial gain, and a voice... why would you use that to lead people in error. There is no such thing as a Progressive or Affirming Christian. God said be in the world and not of the world. Be **transformed** by the renewing of our mines not Conform to societal norms. Understand there will come a day you will have to answer to every idle word and false message that is spread.
I share this in love and respect so that you will repent and come back to the truth. God Bless....
1 Timothy 4:1-2
Now the Spirit speaketh expressly, that in the latter times some shall depart from the faith, giving heed to seducing spirits, and doctrines of devils; speaking lies in hypocrisy; having their conscience seared with a hot iron.
2 Timothy 4:1-4 KJV
I charge thee therefore before God, and the Lord Jesus Christ, who shall judge the quick and the dead at his appearing and his kingdom; preach the word; be instant in season, out of season; reprove, rebuke, exhort with all longsuffering and doctrine. For the time will come when they will not endure sound doctrine; but after their own lusts shall they heap to themselves teachers, having itching ears; and they shall turn away their ears from the truth, and shall be turned unto fables.