No Surprises Act

Your Rights Under the No Surprises Act

Federal law protects patients from unexpected medical bills in certain situations. North Star Psychiatry & Wellness, LLC is committed to helping every patient understand these protections and what they mean for outpatient psychiatric and therapy services.

What "Balance Billing" Means

When you see a provider who is in-network with your health plan, that provider has agreed to a negotiated rate, and you generally only owe your plan's copayment, coinsurance, or deductible. Balance billing happens when an out-of-network provider bills you for the difference between their charge and what your insurance paid. Under the No Surprises Act, this practice is restricted in a number of emergency and certain non-emergency situations.

Your Protections

• You are protected from surprise billing when you receive emergency services, regardless of where they are provided.
• Your health plan must count any amount you pay for emergency services or certain out-of-network services toward your in-network deductible and out-of-pocket limit.
• Your health plan cannot require prior authorization for emergency services.

Good Faith Estimates for Uninsured & Self-Pay Patients

If you don't have insurance, or you choose not to use your insurance to pay for a visit, you have the right to receive a Good Faith Estimate of expected charges before your appointment. This applies to scheduling a new appointment or asking about the cost of services.

• You can ask your provider, or any provider or facility you choose, for a Good Faith Estimate before you schedule an item or service.
• You can also ask any provider or facility for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to keep a copy of your Good Faith Estimate.

How This Applies at North Star

As an outpatient psychiatric practice, most of the services provided at North Star — evaluations, medication management, and therapy — are scheduled visits rather than emergency care. We'll always let you know, before your appointment, whether we are in-network with your plan, what your estimated responsibility will be, and how to request a Good Faith Estimate if you are uninsured or paying out of pocket.