Effective Date: January 1, 2022

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This notice informs patients of their rights under the No Surprises Act, ensuring protection from unexpected medical bills in certain scenarios. It applies to individuals receiving care from nonparticipating providers or facilities.

 

Key Points:

• Nonparticipating providers must provide this notice when applicable.

• Patients have the right to receive a good faith estimate of costs before treatment.

• Consent must be obtained from patients when required, and they may opt not to waive their protections.

 

For detailed information about this notice, visit the No Surprises Act page on CMS.

 

Your Rights and Protections Against Surprise Medical Bills

 

You are protected from surprise medical bills when:

1. Receiving emergency care from an out-of-network provider or facility.

2. Being treated by an out-of-network provider at an in-network hospital or ambulatory surgical center.

 

Key Protections:

• Out-of-network providers cannot balance bill you for emergency or certain ancillary services.

• You are only responsible for in-network cost-sharing amounts (e.g., copayments, coinsurance, and deductibles).​

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For more details, visit the No Surprises Act page on CMS.