Your Right to a Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost

Under federal law, health care providers must give patients who do not have insurance or who are not using insurance an estimate of the expected charges for medical items and services.

What This Means for You

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services such as therapy sessions, psychiatric evaluations, medication management visits, group therapy, psychological testing, and other related costs.

You must receive a Good Faith Estimate in writing at least 1 business day after scheduling (if your appointment is scheduled at least 3 business days in advance).

You can also request a Good Faith Estimate before you schedule any service.

Be sure to save a copy or picture of your Good Faith Estimate.

If You Get a Bill That Is Higher Than Expected

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

You can start the dispute resolution process by visiting www.cms.gov/nosurprises or by calling 1-800-985-3059.

How to Request a Good Faith Estimate

To request a Good Faith Estimate, contact us at:

📞800-284-2615

Important Note: The Good Faith Estimate shows the costs of services that are reasonably expected for your scheduled care. The estimate may change if your treatment plan changes, but you will receive an updated estimate when that happen