NeJame Psychological Services, LLC

No Surprise Act

 

According to the No Surprise Act, healthcare providers need to notify clients who are receiving services that are not utilizing insurance about estimated costs to avoid unexpected charges; therefore, a Good Faith Estimate of services will be provided as part of treatment. Throughout your treatment, your provider may recommend additional items or services as part of your treatment that are not reflected in this estimate which would need to be scheduled separately with your consent and the understanding that any additional service costs are in addition to the initial Good Faith Estimate provided.  If your needs or our rates of services change during treatment, your provider should supply a new, updated Good Faith Estimate to reflect the changes to treatment, and the accompanying cost changes.

 

You may contact NeJame Psychological Services to let us know if the billed charges are higher than the Good Faith Estimate. You can ask us to update the bill to match the Good Faith Estimate or ask to negotiate the bill. The Good Faith Estimate is not a contract between provider and client and does not obligate or require you to obtain any of the listed services from the provider.   If needed, you may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.  There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.  To learn more and get a form to start the process, please go to www.cms.gov/nosurprises or call HHS at (800) 985-3059.