kimberagame
Contributor
Hi everyone,
I'm trying to figure out my clinic's responsibilities under the No Surprises Act. While a lot of it is aimed at larger medical institutions, it seems that some applies to smaller private practices. In particular, I'm trying to understand our obligations when it comes to providing the "good faith estimates" when a patient has a service scheduled. After scheduling a service, we have 1-3 business days, depending on how far out the service is scheduled, to provide our anticipated charges, CPT, and ICD codes to their insurance, or directly to an uninsured patient. The act says this must be done for scheduled items and services. So... if we schedule a nursing visit for vaccines or labs, are we expected to provide this estimate? That doesn't seem to be the intent, but they give no definition of "items and services," and it seems like everything scheduled in advance will fall under this umbrella. Does anyone have information on how this is supposed to work? A more detailed explanation of which scheduled services this estimate is required for? Here's the Act if that's helpful for anyone:
Thanks for any help!
I'm trying to figure out my clinic's responsibilities under the No Surprises Act. While a lot of it is aimed at larger medical institutions, it seems that some applies to smaller private practices. In particular, I'm trying to understand our obligations when it comes to providing the "good faith estimates" when a patient has a service scheduled. After scheduling a service, we have 1-3 business days, depending on how far out the service is scheduled, to provide our anticipated charges, CPT, and ICD codes to their insurance, or directly to an uninsured patient. The act says this must be done for scheduled items and services. So... if we schedule a nursing visit for vaccines or labs, are we expected to provide this estimate? That doesn't seem to be the intent, but they give no definition of "items and services," and it seems like everything scheduled in advance will fall under this umbrella. Does anyone have information on how this is supposed to work? A more detailed explanation of which scheduled services this estimate is required for? Here's the Act if that's helpful for anyone:
Thanks for any help!