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Talbott Recovery
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    When Talbott Recovery opened its doors in the 1980s, we knew that the best way to serve our patients was to be the best at our specialty, to listen carefully to patients, to study our results and to invite family members into the treatment process. Learn More

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    Admissions

    At Talbott Recovery we want to help make this important step you are about to take as simple as possible. We know there can be some anxiety about what happens next, and we are here to demystify the process and provide answers to your questions. Learn More

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Contact

No Surprises Act

Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.

Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get 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.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other 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.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care–like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Additionally, Georgia law protects patients from surprise medical bills for: (i) covered emergency medical services provided by an out of network provider or at an out of network facility and (ii) covered non-emergency services from an out-of-network provider. This prohibition on balance billing does not apply if the covered patient chose to receive non-emergency services from an out-of-network provider and provided oral and written consent.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

Additionally, Georgia law states that these protections require the patient only to pay their in-network cost sharing-amount. These protections apply to patients with coverage through a state healthcare plan, managed care plan or a third party that opts into the prohibition from balance billing.

When balance billing isn’t allowed, you also have the following protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
    • Cover emergency services by out-of-network providers.
    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact:

  • The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
  • The Georgia Office of Commissioner of Insurance and Safety Fire at (800) 656-2298.

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment and hospital fees.
  • Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

Get More Information

For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).

Latest News

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Work With us

At Talbott Recovery you can make a difference in the lives of patients and their families. Join our dedicated, skilled team, and help us as we continue to redefine standards of service excellence. Learn about Talbott Recovery’s employment practices and benefits. Find a list of available positions with Talbott Recovery here.

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Call us now 678-251-3189

Talbott Recovery
5355 Hunter Road
Atlanta, GA 30349
  • About Us
    • History of Talbott
    • Our Team
  • Locations
    • Dunwoody Outpatient
    • Atlanta Main Campus
  • Programs
    • Professionals Treatment Program
    • Pilots Treatment Program
    • Mirror Image
    • Family Program
    • Alumni Support Services
    • Honor Strong Program
  • Treatment
    • Detoxification and Stabilization
    • Partial Hospitalization
    • Intensive Outpatient Programs
  • Resources
    • Online Bill Pay
    • FAQs
  • Admissions
    • The ABC’s of Insurance Coverage
    • How Much Will Treatment Cost?
    • What to Bring
  • Events
  • Careers
  • Contact
Georgia Hospital Association
Alcohol & Drug Abuse Certification Board of Georgia
Foundations Recovery Network, LLC, Drug Abuse Information, Brentwood, TN
Joint Commission Quality Check

Talbott Recovery Campus is dedicated to providing the highest level of quality care to our patients. The Joint Commission’s gold seal of approval on our website shows that we have demonstrated compliance to the most stringent standards of performance, and we take pride in our accreditation. The Joint Commission standards deal with organization quality, safety-of-care issues and the safety of the environment in which care is provided. If you have concerns about your care, we would like to hear from you. Please contact us at 678.251.3100. If you do not feel that your concerns have been addressed adequately, you may contact The Joint Commission at: Division of Accreditation Operations, Office of Quality Monitoring, The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, IL 60181, Telephone: 800-994-6610

Physicians are on the medical staff of Talbott Recovery, but, with limited exceptions, are independent practitioners who are not employees or agents of Talbott Recovery. The facility shall not be liable for actions or treatments provided by physicians. Model representations of real patients are shown. For language assistance, disability accommodations and the non-discrimination notice, visit our website. Affordable transportation options available upon request

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