As of January 1, 2022, under Section 2799B-6 of the Public Health Service Act, health care providers and health care 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 health care items and services, to receive a “Good Faith Estimate” of expected charges.
The truth is that the requirements of this Federal law are already in place for almost all private practice therapists, as our professional associations have strong ethical standards requiring us to:
o inform our clients of fees before commencing treatment
o make it clear that, if you have insurance, you have the option to seek a provider within your network at a lower fee, and
o allow clients who choose to work with someone out-of-network to receive a “superbill” which can be submitted for possible partial reimbursement, depending on the policies of your individual plan (superbills also contain diagnostic codes, which are another requirement of this new bill).
I have always been transparent about the cost of therapy, the benefits of managing one’s own healthcare, as well as the risks and rewards of the use of private health insurance to cover counseling. I encourage financial conversations about the cost of care with my clients and will work to coordinate referrals for treatment with other providers.
Lawmakers will continue to debate the No Surprises Act in an effort to develop standard practices for its implementation at a variety of treatment levels. Within the next six months, individuals using their private health insurance may receive documents from their insurance plans as well. You may receive a Good Faith Estimate from my office prior to your next appointment, and you are welcome to request one from me at any time.
May we walk together bravely into 2022, embracing change and noticing all we experience.
Audrey Jung, LPC LPCC NCC