Good Faith Estimate Notice

As a client, you have the right to receive a Good Faith Estimate outlining the expected cost of your care.

Under federal law, healthcare providers are required to offer cost estimates in advance to individuals who are uninsured or who choose not to use insurance for their services.

Here’s what you should know:

• You’re entitled to a written Good Faith Estimate that includes the total expected costs of non-emergency services. This may cover evaluations, therapy sessions, lab tests, medications, or other related fees.

• You should receive this estimate at least one business day before your scheduled service. You may also request one at any time—even before scheduling an appointment.

• If your final bill is $400 or more above the estimate, you have the right to dispute the charge.

• It’s a good idea to keep a copy of your Good Faith Estimate for your records.

For more details about your rights under the No Surprises Act, visit www.cms.gov/nosurprises or call 1-800-985-3059.