Provided by:  Jennifer Kirschenbaum, Esq.

January 16, 2022


Hi Jennifer, 

I read last week's overview of the No Surprise Law but I'm still confused.  What do I have to post? 

Thank you, Dr. K


Let's get to it!  You have to give the patients and also post a notice explaining - 

  • what is a balance bill
  • what a surprise bill is (non par provider stepping in and rendering services unbeknownst to patient in ASC or Article 28 setting, or airlift, etc.)
  • restrictions on providers sending surprise balance bills
  • applicable state law restrictions 
  • information on contacting appropriate state and federal agencies in the case that an individual believes that a provider or facility has violated the restrictions against balance billing

CMS has a free sample here -  

We have compiled a Federal No Surprise Law form available by contacting Taryn at  We are charging a processing fee of $85.   The Federal No Surprise Law form does not represent our comprehensive NY Out of Network law forms.