Your Rights Under the No Surprises Act
Effective January 1, 2022, you are protected from unexpected medical bills in certain situations and have the right to a Good Faith Estimate of your costs.
Surprise Billing Protections
“Surprise billing” happens when you receive care from an out-of-network provider at a facility (like a hospital or surgery center) without knowing it, and you’re billed more than you would have paid in-network.
Under federal law, if you receive emergency care or certain non-emergency services at an in-network hospital or facility, you can’t be billed more than your in-network cost-share (copay, coinsurance, deductible).
This protection applies to:
Emergency services, even if you get them from an out-of-network provider or facility.
Certain services at an in-network hospital or ambulatory surgical center when performed by an out-of-network provider.
This protection does not apply to most services provided in a private office setting (like typical outpatient mental health therapy). If you have questions about whether it applies to your care, please ask.
Right to a Good Faith Estimate
If you do not have insurance, do not use insurance, or are self-pay, you have the right to receive a Good Faith Estimate (GFE) explaining how much your care will cost.
You will receive a written estimate of the expected charges before your service begins.
You can ask for a GFE at any time before scheduling.
If you receive a bill that is $400 or more than your GFE, you can dispute it.
You must receive your GFE:
Within 1 business day if your appointment is scheduled 3–9 business days in advance.
Within 3 business days if your appointment is scheduled 10 or more business days in advance.
Within 3 business days of a request if you haven’t scheduled yet.
If You Think Your Rights Have Been Violated
You can contact:
Illinois Department of Insurance: https://insurance.illinois.gov
Centers for Medicare & Medicaid Services (CMS): 1-800-985-3059 or https://www.cms.gov/nosurprises
This notice is required by law and is intended to help you understand your rights and protections.