Good Faith Estimate

No Surprises Act

  1. Under the No Surprises Act, clients who are seeking out-of-network services are entitled to receive a “Good Faith Estimate” of how much their care will cost, prior to receiving care. The good faith estimate is not a bill.
  2. The “Good Faith Estimate” is a notification that outlines an uninsured (or self-pay) individual’s expected charges for a scheduled or requested item or service.
  3. The estimate is based on information known at the time the estimate was created. As such, due to an individual’s treatment needs, depending on the complexity and severity of presenting issues as well as the degree of personal investment towards improvement, the duration of treatment may vary significantly. We will provide an estimate for an average annual cost of care.
  4. If you receive a bill that is at least $400 or more than your Good Faith Estimate, you can dispute the bill. There’s a $25 non-refundable administrative fee to start this process.
  5. Make sure to save a copy of your Good Faith Estimate, which can also be accessed via your Client Portal.
  6. For more information about the No Surprises Act, you can visit www.cms.gov/nosurprises or call 1-800-985-3059.