Good Faith Estimate Notice

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

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

Make sure your healthcare provider gives you a Good Faith Estimate in writing at least 1 business day before your scheduled item or service.

You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, then 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 and the dispute process, visit https://cms.gov/nosurprises/consumers or call 1-800-985-3059.