GOOD FAITH ESTIMATE

Your right to understand the cost of your care.

Under the federal No Surprises Act, individuals who do not have health insurance or who choose not to use their health insurance to pay for care generally have the right to receive a Good Faith Estimate of the expected cost of services.

A Good Faith Estimate explains the reasonably expected charges for your care based on the information available at the time the estimate is prepared. It is not a bill and does not require you to receive services from Progressing Minds.

YOUR GOOD FAITH ESTIMATE

What you can expect.

If you are uninsured or plan to pay for services yourself without submitting a claim to your health plan, you may request a Good Faith Estimate before scheduling services.

When services are scheduled sufficiently in advance, you may also be entitled to receive a Good Faith Estimate before your appointment. Your estimate will identify the services reasonably expected to be provided and the expected charges based on the information available at that time.

Because psychotherapy is individualized and the length and frequency of treatment may change over time, your estimate may be updated as your treatment needs or our fees change.

IF YOUR BILL IS HIGHER THAN YOUR ESTIMATE

If you receive a bill from a provider that is at least $400 more than that provider's Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process.

Generally, the dispute must be started within 120 calendar days of the date on the initial bill.

For more information about Good Faith Estimates and your rights under the No Surprises Act, visit the Centers for Medicare & Medicaid Services (CMS) or call the No Surprises Help Desk at 1-800-985-3059.