The No Surprise Billing Act (NSA). You might have heard of it. You might have even tried to read the thing.
In my opinion, it may be the most poorly written, difficult to understand set of regulations I have encountered in my career. Much of the guidance, especially from the Chiropractic Community, is misleading, if not entirely wrong. Here is a summary of what you need to know.

Does NSA Apply to Clinics?
It does, in part. This is one of the more confusing areas, and many sources mistakenly state that the rules do not apply to clinics. It might be wise, to think of the NSA as having three faces. One face deals with emergency services, one deals with patients who are getting care at a hospital or ASC (it also applies to freestanding EDs or air ambulances.), and the final face deals with estimates for patients who are not using insurance to pay for their care, either because they are uninsured or choosing not to use their insurance (per HIPAA the patient can request certain data not be released, essentially prohibiting billing insurance).
That third face applies to clinics. Clinics will have to give estimates to patients who are not using insurance to pay for their care. The first two faces will apply in clinics to the extent that clinic physicians provide services to clinic patients in either a hospital or an ASC. For the most part, the other two faces do not apply in the clinic, but if you send patients to a hospital or ASC, you will need to post a one-page notice somewhere in your clinic and provide a copy of that notice to the patients being sent to the hospital or ASC.

What is the Good Faith Estimate?
This is the face of the rule that applies to all physicians. As of January 1, 2022, if a patient is not using insurance to pay for their care, they are entitled to a Good Faith Estimate (GFE) of their respect for any service scheduled three or more business days in advance. The GFE must include a long list of things; simply telling them the cost is insufficient. For reasons I can’t fathom, the GFE must consist of details like the diagnosis and procedure codes and even your NPI.
This applies to every scheduled service, including office visits, if designed three or more days out. When the event is scheduled between three and nine days off, you must provide the estimate within one business day the scheduling takes place. If the event is scheduled ten or more days out, you get three business days to give the estimate.
What happens if we don’t give the estimate?
At this time, there are no direct penalties for failing to give the estimate, but the patient can challenge your bill. In the absence of an estimate, or if the forecast understates the charge by $400 or more dollars, the patient can file for a dispute resolution procedure. In addition, when civil monetary penalties are issued in the future, there may be fines for failure to give the GFE.
There are a variety of other resources but be careful. Even information from some well-known trade groups is just flat-out wrong.