Good Faith Estimate Notice

Your Right to Receive a Good Faith Estimate

Under the law, health care providers are required to provide clients who do not have insurance or who are not using insurance with an estimate of the expected charges for medical and mental health services.

You have the right to receive a Good Faith Estimate explaining the anticipated cost of your mental health care services.

The Good Faith Estimate includes expected costs for services reasonably related to your care, including psychotherapy services.

You may request a Good Faith Estimate before scheduling a service or at any time during treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

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