Good Faith Estimate Notice

 You have the right to receive a “Good Faith Estimate” (GFE) explaining the expected cost of your mental health care.
Under the No Surprises Act (effective January 1, 2022), health care providers must provide a Good Faith Estimate to individuals who:

• Do not have insurance, or

• Are choosing not to use their insurance (self-pay or out-of-network)

What You Can Expect:

• You will receive a written estimate of the cost of services before your first appointment or upon request.

• The estimate will include the expected charges for services you’re scheduled to receive.

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

By understanding the Good Faith Estimate and using it effectively, you can take control of your healthcare costs and make informed decisions about your mental health.
For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, see your estimate or visit www.cms.gov/nosurprises.
Contact us if you have questions about receiving a Good Faith Estimate.