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No Surprise Billing Act

KNOW YOUR RIGHTS

Effective January 1, 2022

The “No Surprise Billing Act,” is a law establishing federal standards to resolve surprise bills for patients. The law applies to emergency services at out-of-network hospitals, out-of-network facilities and ambulance services.

We are required to provide you with advance notice if we are out of-network with your health plan.

Prior to services being provided, we will provide you with a “Good Faith Estimate,” and ask you to sign an acknowledgement that you have received the information and understand your cost-sharing limits.

We will ask you to sign a consent form accepting financial responsibility. This consent is voluntary. You can also choose to receive the items or services from an in-network provider.

If an authorization is needed, we will help you obtain one.

If you get billed for an amount not provided in the good faith estimate, please contact our office at 360-496-3707 so we can review your account and resolve any disputes.