YOUR RIGHT TO A GOOD FAITH ESTIMATE

​

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in an insurance plan or a Federal health care program, or who are not submitting a claim to their insurance, of their right to receive a "Good Faith Estimate" of expected charges.

​

• Right to an Estimate: You have the right to receive a Good Faith Estimate detailing the expected cost of your mental health care.

• Timeline: A Good Faith Estimate must be provided in writing at least 1 business day before your medical service or item is scheduled. You can also ask for an estimate before you schedule an item or service.

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

​

​

Note: The Good Faith Estimate is an estimate of expected clinical fees and is not a contract. It does not obligate you to obtain services from this practice.