No Surprises Act

Dentist Filling Out Form

The No Surprises Act is a federal law that protects patients from surprise billing and other practices that result in financial burdens for patients. While most of this law does not impact private dentistry, the law’s requirements regarding transparency of health care costs could apply to private dental offices, based on the patient being treated. The links below have information and sample forms to help your practice deliver care to your patient, while complying with the No Surprises Act.

ADA information on No Surprises Act

Find out how does the No Surprises Act, which gives consumers new 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 affect dentists.

Federal No Surprises Act may affect dentists

While the federal No Surprises Act requirements pertaining to balance billing largely do not apply to private dental offices, the law’s requirements regarding transparency of health care costs could apply to private dental offices depending on the type of patient being provided a service.

Good Faith Estimate for dental care items and services form

Available in Microsoft Word format, this form allows dentists to provide a Good Faith Estimate for the total expected cost of dental care items and services necessary to treat a patient.

Notice of uninsured and self-pay patient’s right to good faith estimate

Dental offices must give patients who don’t have certain types of dental coverage or who are not using certain types of dental coverage an total cost estimate for dental items and services.