The American Dental Association recently received clarification from CMS about how dental professionals are affected by the No Surprises Act.
Four things to know:
1. The No Surprises Act went into effect Jan. 1, 2022, requiring good faith estimates for the cost of care to be given to uninsured and self-pay consumers.
2. The act gives consumers billing protections when getting emergency care, nonemergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.
3. According to CMS, dental providers and facilities are generally required to provide good faith estimates of expected charges unless the patient is enrolled in an excepted benefit plan or coverage, such as a stand-alone dental plan.
4. CMS noted that providers or facilities are not required to verify coverage for each item or service with the patient’s plan or issuer. Providers and facilities can determine whether the individual is uninsured or self-pay based on inquiries under the act, according to a Feb. 28 news release.