Good Faith Estimate Notice

If you do not have insurance or are not using your insurance to pay for your services (you are paying out-of-pocket), you have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers must give patients who don’t have insurance or who are not using their insurance (paying out-of-pocket for services) an estimate of the expected charges for medical services, including psychotherapy services. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

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

© 2022 Eastlake Community Counseling, Jeff Palitz, MFT, Inc., Chula Vista, CA