Your Right to Receive a Good Faith Estimate of Expected Charges

Under the No Surprises Act, if you are paying for counseling yourself and not billing insurance, you have the right to receive a Good Faith Estimate explaining how much your care is expected to cost.

• You can ask your therapist or our team for a Good Faith Estimate for any service, before you schedule.

• When you schedule a service, you will receive a written Good Faith Estimate of expected charges.

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

• Keep a copy of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.