Good Faith Estimate
Your Right to Receive a Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your health care services are expected to cost.
Under federal law, health care providers generally must provide a Good Faith Estimate to individuals who do not have health insurance or who choose not to use their insurance to pay for services.
Your right to an estimate: You may request a Good Faith Estimate of the expected cost of counseling services before scheduling or at any time during treatment.
When you receive an estimate: If you schedule services at least 3 business days in advance, you generally must receive an estimate within the applicable federal time frame. You may also request an estimate before scheduling services.
What the estimate includes: The estimate outlines the expected charges for the health care services provided by the provider issuing the estimate.
Your right to dispute a bill: 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 dispute the bill through the federal Patient-Provider Dispute Resolution process.
Keep a copy: Save a copy of your Good Faith Estimate and compare it with your bill.
A Good Faith Estimate is an estimate of expected charges, not a guarantee of the final cost.
For more information about your rights, how to request an estimate, or how to dispute a bill, visit the Centers for Medicare & Medicaid Services:
Your Right to Receive a Good Faith Estimate — CMS
Learn how to dispute a medical bill — CMS
If you are paying out of pocket for counseling services, contact Ashley Haisler or the practice responsible for your care to request your individualized Good Faith Estimate.