Your Right to Receive a Good Faith Estimate
You Have the Right to Receive a Good Faith Estimate of Expected Charges
Under the No Surprises Act, individuals who do not have health insurance or who choose not to use their health insurance to pay for health care services generally have the right to receive a Good Faith Estimate explaining how much their care is expected to cost.
If you are uninsured or are choosing to pay for services yourself without submitting a claim to your health insurance plan, you may request a Good Faith Estimate before scheduling services.
You may also be entitled to receive a Good Faith Estimate after scheduling services in advance.
What Is a Good Faith Estimate?
A Good Faith Estimate provides an estimate of the expected charges for health care services that are reasonably expected based on the information available at the time the estimate is prepared.
The estimate is not a bill or a contract requiring you to receive services.
The actual services you receive may differ from those initially anticipated based on your clinical needs, treatment decisions, frequency of services, or other circumstances.
When Will I Receive an Estimate?
If you are uninsured or choosing not to use your insurance:
If services are scheduled at least 3 business days in advance, you generally have a right to receive a Good Faith Estimate.
If services are scheduled 3–9 business days in advance, the estimate generally must be provided within 1 business day after scheduling.
If services are scheduled 10 or more business days in advance, the estimate generally must be provided within 3 business days after scheduling.
If you request a Good Faith Estimate before scheduling services, one generally must be provided within 3 business days of your request.
You may request a Good Faith Estimate at any time.
Ongoing Psychotherapy
Psychotherapy does not always have a predetermined number of sessions.
When appropriate, a Good Faith Estimate may therefore include expected charges associated with a reasonably anticipated course of treatment based on the information available at the time the estimate is prepared.
The frequency or duration of therapy may change based on your needs, treatment goals, clinical recommendations, scheduling, or your decision about whether to continue services.
An updated estimate may be provided when appropriate if expected services or costs change substantially.
If Your Bill Is Higher Than Your Estimate
If you receive a bill from a provider that is at least $400 more than the amount listed on the Good Faith Estimate from that provider, you may be eligible to use the federal patient-provider dispute resolution process.
Keep a copy of your Good Faith Estimate so that you can compare it with future bills.
Questions or Requests
To request a Good Faith Estimate or ask questions about expected charges, please contact:
Jabrielle Mason MEd LCSW PLLC
Jabrielle Mason, MEd, LCSW
Phone: 682-306-4991
Email: Jabrielle.Mason@gmail.com
Additional information about your rights under the No Surprises Act is available through the Centers for Medicare & Medicaid Services.