Good Faith Estimate

Last updated: August 28, 2024

As a licensed professional counselor, I am committed to providing transparent pricing for the services I offer. The Good Faith Estimate aims to inform you about the costs of your care before you begin treatment.

Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining how much your healthcare will cost. Healthcare providers must give patients who don’t have insurance, or who are not using insurance, an estimate of the expected costs for any non-emergency medical items or services. This includes mental health therapy and counseling services.

You should receive your Good Faith Estimate in writing at least one business day before your scheduled service or item. You can also request a Good Faith Estimate from your provider at any time, even before you schedule a service.

This estimate is not a contract and doesn’t obligate you to receive services from the listed provider. It’s also based on the information known at the time and doesn’t include any unexpected costs that may arise during treatment. Be sure to save a copy or picture of your Good Faith Estimate for your records.

If you receive a bill that exceeds your estimate by $400 or more, you can start a dispute process with the U.S. Department of Health and Human Services (HHS) within 120 days of receiving the bill. There is a $25 fee for this process. If the review is in your favor, you will only be responsible for paying the amount in your Good Faith Estimate.

For questions or more information about your rights to a Good Faith Estimate, visit www.cms.gov/nosurprises