The No Surprises Act: A Compliance Refresher For Dental Practices
Jordan Uditsky • July 19, 2023
It has been a few years since the federal No Surprises Act (the “Act”) went into effect. Enacted as part of the Consolidated Appropriations Act of 2021, the Act focuses on protecting patients from unexpected health care bills. For dentists, much of the law is irrelevant, such as provisions relating to balance billing. But the Act’s billing transparency requirements, including providing good-faith estimates to certain types of dental patients, are very much applicable.
Hopefully, your dental practice has long since been in compliance with the Act. But by way of a quick refresher, here is what practice owners need to know and do to satisfy the law’s billing provisions.
Only Applicable to Uninsured and Self-Pay Patients
The Act’s disclosure requirements do not apply to all dental patients, only uninsured or self-pay patients. An uninsured patient is one who is not enrolled in a group or individual dental plan, a Federal health care program, or a Federal Employees Health Benefits (FEHB) program health benefits plan. A self-pay patient is a person who has dental benefits but elects not to submit a claim to a dental plan for payment. A non-covered service or any cost exceeding the annual maximum for the patient’s dental plan is also considered “self-pay.”
Good Faith Estimate Upon Request
Dentists' primary obligation under the Act is to provide written good-faith estimates in advance of services to uninsured and self-pay patients upon their request. Information regarding the availability of good-faith estimates must be written in clear and understandable language and prominently displayed on the practice’s website and in its offices. CMS has developed a model notice that providers can use to satisfy this requirement.
If an uninsured or self-pay patient asks for a good-faith estimate, the dentist must provide a written summary of their expected costs for services and items within the following timeframes:
- For a primary item or service scheduled at least three business days before the date the item or service is to be furnished, the dentist must provide the good-faith estimate no later than one business day after the date of scheduling.
- When a primary item or service is scheduled at least ten business days before such item or service is to be furnished, the dentist must provide the estimate no later than three business days after the date it is scheduled.
- When an uninsured or self-pay individual requests a good-faith estimate, the dentist must provide the good-faith estimate no later than three business days after the date of the request.
CMS has established a detailed list of what providers should include in the good-faith estimate, including, among other items:
- A list of items and services the dentist expects to provide for the period of care
- Any services that an outside agency associated with the facility may provide (e.g., if oral surgery requires the use of an anesthesiologist, the estimate must include their costs and services)
- Diagnostic and service codes
- Notification that if the bill is significantly higher than the estimate, it may be updated, negotiated, or financial assistance may be available
- Dispute resolution information and instructions
On that last point, the rules implementing the Act provide that if the bill for the primary procedure is more than $400 higher than the good-faith estimate, the patient can dispute the charges through the Patient-Provider Dispute Resolution process established by CMS.
Contact Us With Any Questions or Concerns
If you have any questions or concerns about compliance with the No Surprises Act, please give us a call. At Grogan, Hesse & Uditsky, P.C., we focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you.
Please call us at (630) 833-5533 or contact us online to arrange for your free initial consultation.
Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
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If you are a dental professional considering a sale or merger, please contact us at ddslawyers.com at (630) 833-5533 or contact us online to arrange for your complimentary initial consultation. We focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you. Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices, and this blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
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Anyone associated with a practice cannot do any of the following: Complete any portion of an application for financing extended by a third party for a patient or patient's guardian. Provide the patient or patient's guardian with an electronic device to apply for financing extended by a third party. Promote, advertise, or provide marketing or application materials for financing extended by a third party to a patient who has been administered or is under the influence of general anesthesia, conscious sedation, moderate sedation, or nitrous oxide; is being administered treatment; or is in a treatment area, including, but not limited to, an exam room, surgical room, or other area when medical treatment is administered, unless an area separated from the treatment area does not exist. Mandatory Disclosure When discussing or providing applications for financing extended by a third party, a dentist, employee of a dentist, or agent of a dentist must provide the following written notice in at least 14-point font: DENTAL SERVICES THIRD-PARTY FINANCING DISCLOSURE This is an application for a CREDIT CARD, LINE OF CREDIT, OR LOAN to help you finance or pay for your dental treatment. This credit card, line of credit, or loan IS NOT A PAYMENT PLAN WITH THE DENTIST'S OFFICE. It is a credit card, line of credit, or loan from a third-party financing company. Your dentist does not work for this company. Your dentist may not complete or submit an application for third-party financing on your behalf. You do not have to apply for a credit card, line of credit, or loan. You may pay your dentist for treatment in another manner. Your dentist's office may offer its own payment plan. You are encouraged to explore any public or private insurance options that may cover your dental treatment. The lender or creditor may offer a "promotional period" to pay back the credit or loan without interest. After any promotional period ends, you may be charged interest on portions of the balance that have already been paid. If you miss a payment or do not pay on time, you may have to pay a penalty and a higher interest rate. If you do not pay the money that you owe the creditor or lender, then your missed payments can appear on your credit report and could hurt your credit score. You could also be sued by the creditor or lender. If your dentist's office has completed or submitted an application for third-party financing on your behalf, you may file a complaint by contacting the Illinois Department of Financial and Professional Regulation at https://idfpr.illinois.gov/admin/dpr/dprcomplaint.html or by calling (312) 814-6910." Penalties for Non-Compliance A violation of these new rules and limitations is punishable by a fine of up to $500 for the first violation and a fine of up to $1,000 for each subsequent violation. IDFPR has the power to take additional disciplinary action as well. If you have any questions about these new requirements or third-party financing for dental services generally, please contact Jordan Uditsky at Grogan Hesse & Uditsky. We Focus on You So You Can Focus on Your Patients At Grogan Hesse & Uditsky, P.C., we focus a substantial part of our practice on providing exceptional legal services for dentists and dental practices, as well as orthodontists, periodontists, endodontists, pediatric dentists, and oral surgeons. We bring unique insights and deep commitment to protecting the interests of dental professionals and their practices and welcome the opportunity to work with you. Please call us at (630) 833-5533 or contact us online to arrange for your free initial consultation. Jordan Uditsky, an accomplished businessman and seasoned attorney, combines his experience as a legal counselor and successful entrepreneur to advise dentists and other business owners in the Chicago area. Jordan grew up in a dental family, with his father, grandfather, and sister each owning their own dental practices. This blend of legal, business, and personal experience provides Jordan with unique insight into his clients’ needs, concerns, and goals.
