April 22, 2024
shrinkMD complies with the No Surprises Act, effective January 1, 2022, to protect our patients from unexpected medical bills, known as “surprise billing.” This legislation ensures transparency and fairness in healthcare billing, especially when services are provided by out-of-network professionals or during emergencies.
Your Protections Under the No Surprises Act
Emergency Services:
If you receive emergency care from an out-of-network provider, you are only responsible for in network cost-sharing amounts such as deductibles, copayments, and coinsurance.
Non-Emergency Services at In-Network Facilities:
If you receive services from an out-of-network provider at an in-network facility, you will not be charged more than the in-network rate for these services, effectively protecting you from balance billing.
Good Faith Estimate:
shrinkMD will provide a “Good Faith Estimate” of expected charges for healthcare services if you are uninsured or not using insurance. This estimate will help you anticipate potential costs and plan your finances accordingly.
Consent for Out-of-Network Charges:
You will be informed and your consent obtained for any out-of-network services that could result in balance billing. This ensures that you are aware of potential charges and your financial responsibilities before services are rendered.
Fees and Billing:
While specific costs are clearly written on our website, shrinkMD is considering a membership model where patients pay a recurring fee to access services. This model aims to simplify billing and ensure predictable healthcare costs. If there are any changes to the membership model or you chose to do a fee for service, the cost of this will be clearly posted on the website.
Dispute Resolution:
If you are billed more than the provided Good Faith Estimate, you have the right to dispute the charge. You can initiate a dispute resolution process through the U.S. Department of Health and Human Services (HHS) within 120 days of the bill.
State-Specific Rights:
shrinkMD adheres to local regulations in the states it operates, including Florida, Georgia, California, Texas, Virginia, Indiana, Maine, New York, Hawaii and all the states shrinkMD serves. These regulations provide additional protections against surprise billing. For state specific information or to understand more about balance billing protections:
- California: California Department of Insurance http://www.insurance.ca.gov/01-consumers/101- help/index.cfm or call (800) 927-4357
- Florida: Florida Office of Insurance Regulation – https://www.floir.com/
- Georgia: Georgia Consumer Protection – https://consumer.georgia.gov/consumer-topics/hospital billing-practices
- Texas: Texas Department of Insurance – https://texaslawhelp.org/article/surprise-medical-bills or call (800) 252-3439
- Virginia: Virginia State Corporation Commission – https://scc.virginia.gov/pages/Balance-Billing-Protection
Disclaimer:
For additional guidance or to begin a dispute resolution, contact us directly or visit the federal No Surprises website for comprehensive details. Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.
shrinkMD remains dedicated to enhancing compliance and patient care standards continuously, adapting our practices to meet the evolving needs and protections of our patients.
Should you have additional questions about your rights under this act, you can contact any of the following: The U.S. Centers for Medicare & Medicaid Services (CMS) at 1- 800-MEDICARE (1-800-633-4227) or visit for more information about your rights under federal law. The Department of Insurance, Office of Consumer Health Insurance in your jurisdiction.
If you are billed for more than this Good Faith Estimate you have the right to dispute the bill. You may start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 days (about 4 months) of the date on the original bill.
If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the healthcare provider, you will have to pay the higher amount.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email [email protected], or call 1- 800-985-3059.
