Your Right to Receive a Good Faith Estimate

Under the No Surprises Act, individuals who are uninsured or who choose not to use their health insurance for services have the right to receive a Good Faith Estimate (GFE) outlining the anticipated costs of their healthcare.

A Good Faith Estimate provides an estimate of the expected charges for non-emergency healthcare services, including psychotherapy and any related services or fees that may apply.

You are entitled to receive a written Good Faith Estimate at least one business day before your scheduled service. You may also request an estimate from your healthcare provider before scheduling an appointment or service.

If you are billed $400 or more above the amount listed on your Good Faith Estimate, you have the right to dispute the charges through the process established under federal law.

Please keep a copy of your Good Faith Estimate for your records.

For additional information about your rights under the No Surprises Act and the Good Faith Estimate requirements, please visit the Centers for Medicare & Medicaid Services website at https://www.cms.gov/nosurprises.