Notice of Good Faith Estimate

Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

If you are not planning to use insurance to cover any part of your treatment, your health care provider can give you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can ask your health care provider for a Good Faith Estimate before you schedule services.

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.

For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, see your Estimate, or visit: https://www.cms.gov/nosurprises.