No Surprises Act & Your Rights at Catalyst Orthopaedics & Sports Medicine

What is the No Surprises Act?

The No Surprises Act is a federal law, effective January 1, 2022, that protects patients from unexpected medical bills. It ensures you won’t be caught off-guard by charges from out-of-network providers you did not knowingly choose.

Your Protections Under the Law

  • You can’t be charged more than your in-network cost-share for emergency services, even if provided out of network.
  • You can’t be billed extra for certain out-of-network services at an in-network hospital or ambulatory surgical center without your consent.
  • You have the right to a Good Faith Estimate of expected charges if you are uninsured or not using insurance.

Catalyst Orthopaedics & Sports Medicine’s Commitment

We comply fully with the No Surprises Act. That means:

  • We will not bill you for more than the in-network cost share for covered services.
  • We provide Good Faith Estimates for uninsured/self-pay patients before services are rendered.
  • We are available to help answer billing questions and work with you if something doesn’t look right.

CMS Required Disclosure Language

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
catalystorthoidaho.

What is “balance billing”?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, or deductible. You may have additional costs or have to pay the
entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network. “Balance billing” happens when an out-of-network provider bills you for the difference between
what your plan pays and the full amount charged.

You are protected from balance billing for:

  • Emergency services (even if provided by an out-of-network provider or facility).
  • Certain services at an in-network hospital or ambulatory surgical center when the provider is out of network.

You are never required to give up your protections from balance billing.

You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.

Good Faith Estimates for the Uninsured or Self-Pay Patients

If you don’t have insurance, or if you’re choosing not to use your insurance, you have the right to receive a “Good Faith Estimate” of expected charges before you get care. If your actual bill is at
least $400 more than your estimate, you may be able to dispute the bill.

For questions or more information about your rights under federal law:

Visit cms.gov/nosurprises or call 1-800-985-3059.

Contact Catalyst Orthopaedics & Sports Medicine

If you have any questions or concerns about your bill, or if you need a Good Faith Estimate, please contact us:

Tel: (208) 321-1209
Fax: (208) 321-1211
Mail: hello@catalystorthoidaho.com
Text us via the Klara app