No Surprises Act & Good Faith Estimates

Understanding the No Surprises Act

The No Surprises Act, effective January 1, 2022, is a federal law that protects patients from unexpected medical bills for out-of-network or uninsured care. It ensures transparency in healthcare pricing and gives patients the right to receive upfront information about their costs before treatment begins.

At California Prime Recovery, we comply fully with this law by providing Good Faith Estimates to all uninsured and self-pay clients. This ensures that every client understands their expected treatment costs prior to admission.

What Is a Good Faith Estimate?

A Good Faith Estimate outlines the expected charges for services, including therapy, medical care, testing, and other treatment-related expenses. It helps you understand what your care may cost and prevents unexpected billing.

You are entitled to:

• A written estimate before starting treatment if you are uninsured or self-pay.

• A detailed breakdown of costs for each service or level of care.

• Information about how to dispute charges if your final bill is $400 or more than the estimate.

How to Request a Good Faith Estimate

You can request a Good Faith Estimate at any time before scheduling or starting treatment. Our admissions specialists will review your treatment plan, discuss your financial options, and provide a written estimate. Estimates are available for all levels of care, including detox, residential treatment, PHP, IOP, and outpatient services.

To request a Good Faith Estimate, contact our admissions team at 844-349-0077.

What to Do If Your Bill Is Higher Than Expected

If your bill is $400 or more above your Good Faith Estimate, you have the right to dispute the charges. You can:

1. Contact our billing department to review and resolve any discrepancies.

2. Submit a formal dispute through the U.S. Department of Health and Human Services within 120 days of receiving the bill.

3. Visit www.cms.gov/nosurprises for detailed information about the dispute process.

Your Rights and Protections

You have the right to:

• Receive an estimate of your total treatment cost before care begins.

• Request an itemized list of charges at any time.

• Be free from surprise or balance billing for uninsured services.

• File a dispute if your charges exceed the estimate by $400 or more.

For more information about your rights under the No Surprises Act, visit www.cms.gov/nosurprises

Conclusion

At California Prime Recovery, we’re dedicated to transparency and patient trust. Whether you’re insured, self-pay, or exploring financing options, our goal is to ensure you always understand the cost of care before treatment begins. For questions or to request a Good Faith Estimate, call 844-349-0077 to speak with our admissions team today.

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