In accordance with the No Surprises Act, health care providers are required to give clients who don’t have insurance or who are not using insurance an estimate of the bill for medical services. This is called a Good Faith Estimate, and it shows the costs of items and services that are reasonably expected for your health care needs.

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

You have the right to ask for a Good Faith Estimate before you schedule a service and/or at any time during your treatment. If your needs change during treatment, your provider should supply a new, updated Good Faith Estimate to reflect the changes to treatment, and the accompanying cost changes.

The estimate will include the expected costs for services such as intake sessions, individual therapy, and/or other services we discuss and agree upon.

The Good Faith Estimate is not a contract between provider and client and does not obligate or require the client to obtain any of the listed services from the provider.

If you receive a bill that is $400 or more than your Good Faith Estimate, you have the right to dispute the bill. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call HHS at (800) 985-3059.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call (800) 985-3059.