Rachel A. Gardner | Southern Tier  Psychology

INFORMATION ABOUT THE "NO SURPRISES" ACT

This notice serves to address the new federal “no surprises” act that was enacted on 1/1/22 and clarify how it relates to the practice of psychology. All healthcare providers are now required to notify clients of their federal rights and protections against “surprise billing.” It requires that we notify you of your federally protected rights to receive a notification when services are rendered by an out-of-network provider, if a client is uninsured, or if a client elects not to use their insurance.

The act was developed in response to situations where patients receive unexpected charges for medical procedures. For example, some hospitalized patients found that providers involved in their direct care did not participate with their insurance. Even though they had no control over who treated them while in the hospital, they were nonetheless held responsible for charges that they never authorized.

The “No Surprises” act should be very helpful in such situations and protect vulnerable patients. It carries the expectation that all potential services should be outlined ahead of time. The broad sweep of this act, though, encompasses outpatient healthcare providers and out-of-network psychologists who provide individual services, and where unexpected charges rarely occur. It presumes that clients may encounter unexplained charges throughout the course of psychotherapy. It also presumes that psychologists can accurately predict each client’s long-term cost of treatment. Both assumptions are not relevant to most outpatient psychotherapy practices.

I am required to provide you with a Good Faith Estimate of the cost of services if I am not in-network with your insurance company. Psychotherapy consists of individual appointments – not a service involving multiple providers, or a “package” limited to a set number of sessions. Most people enter psychotherapy quite aware that neither they nor the therapist can clearly predict how many sessions will be needed. I honor each client’s choices and goals along the way. Although I may offer my professional recommendations related to the benefits of weekly sessions or when fewer sessions are needed, I always leave it up to the client to decide when they wish to decrease the frequency of sessions or stop therapy.

I am including this information on my website, as now required by law, but with the awareness that it is not reflective of my practice as a psychologist. I am always clear about my fees, and please know that I will never "surprise" you with an unexpected bill. 

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under federal law.