No Surprises Act & Good Faith Estimates

Your Right to a Good Faith Estimate

Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining the expected cost of psychotherapy services if you do not have insurance or choose not to use insurance.

As a self-pay client, you may request a Good Faith Estimate for the total expected cost of services at any time and before scheduling. A Good Faith Estimate will be provided in writing prior to the start of services or upon request.

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

For more information about your rights under the No Surprises Act, visit Centers for Medicare & Medicaid Services at www.cms.gov/nosurprises.

To request a Good Faith Estimate or ask questions, please contact: dawn@therapywithdawn.com