Good Faith Estimate Notice

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

Under the No Surprises Act, health care providers are required to provide clients who are uninsured or who choose not to use insurance with an estimate of expected charges for non-emergency services, 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.

Be sure to keep a copy of your Good Faith Estimate for your records.

For more information about your rights under the No Surprises Act, visit CMS No Surprises Act Information or call (800) 985-3059.

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