Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.
Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. 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 an unexpected balance bill. This can happen when you can’t control who is involved in your care–like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Additionally, Georgia law protects patients from surprise medical bills for: (i) covered emergency medical services provided by an out of network provider or at an out of network facility and (ii) covered non-emergency services from an out-of-network provider. This prohibition on balance billing does not apply if the covered patient chose to receive non-emergency services from an out-of-network provider and provided oral and written consent.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
Additionally, Georgia law states that these protections require the patient only to pay their in-network cost sharing-amount. These protections apply to patients with coverage through a state healthcare plan, managed care plan or a third party that opts into the prohibition from balance billing.
When balance billing isn’t allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
If you believe you’ve been wrongly billed, you may contact:
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
Get More Information
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).
Privacy Policy
1. Introduction
Hope Springs Mind Body Spirit, LLC ("we," "our," "us") is committed to protecting your privacy. This Privacy Policy outlines how we collect, use, and protect your personal information when you visit our website, contact us, or use our services.
2. Information We Collect
We may collect personal information that you provide to us directly, including your name, email address, phone number, and any other information you choose to share. Additionally, we may collect non-personal information about your visit to our website, such as your IP address, browser type, and pages viewed.
3. How We Use Your Information
We use your personal information to:
4. SMS Messaging Policy
If you provide us with your phone number, you consent to receive SMS messages from Hope Springs Mind Body Spirit, LLC. These messages may include appointment reminders, updates, and information about our services.
5. Data Protection
We take reasonable measures to protect your personal information from unauthorized access, disclosure, or misuse. Our website may use encryption and secure protocols to safeguard your data. However, no method of transmission over the internet is entirely secure, and we cannot guarantee absolute security.
6. Sharing Your Information
We do not sell, trade, or share your personal information with third parties for marketing purposes. We may share information when legally required or to protect our rights.
7. Your Rights
You have the right to:
8. Changes to This Policy
We may update this Privacy Policy from time to time. Any changes will be posted on this page, and the "Last Updated" date will be revised accordingly.
9. Contact Us
If you have any questions or concerns about this Privacy Policy, please contact us at:
Hope Springs Mind Body Spirit, LLC
Phone: 678-635-3136
Email: administrator@hopespringscounseling.org
Address: 706 South Broad, Monroe, GA
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