Good Faith Estimate
Under the federal No Surprises Act, you have the right to know what your care will cost before you receive it.
Your right to a Good Faith Estimate
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 clients who are uninsured, or who are not using insurance, 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 services, including psychotherapy.
- 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.
How this practice handles it
If you are not using insurance, you will receive a written Good Faith Estimate before your first session — you do not need to ask for it. It sets out the expected fee per session and the anticipated frequency and duration of care, based on what we discuss in the consultation.
Current private-pay fees
Standard session: Out of pocket is a sliding scale
Initial session: Out of pocket is a sliding scale
Because therapy is not a fixed-length treatment, an estimate is exactly that — an estimate. The number of sessions someone needs varies, and you and I will review the plan regularly. If the expected course of care changes significantly, you will receive an updated estimate.
If you are using insurance
The Good Faith Estimate requirement applies to uninsured and self-pay clients. If you are using insurance through Headway, your expected cost per session is shown during booking, based on your plan's copay, coinsurance, and deductible.
Disputing a bill
If you are billed at least $400 more than your Good Faith Estimate, you may start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). You must begin the process within 120 calendar days of the date on the bill. There is a fee to use the dispute process. If the reviewer agrees with you, you will pay the price on the Good Faith Estimate; if the reviewer disagrees, you will pay the higher amount.
To learn more about your rights, or to start a dispute, visit www.cms.gov/nosurprises or call 1-800-985-3059.
Requesting an estimate
You can request a Good Faith Estimate at any time, before scheduling or at any point during care. Contact the practice at (732) 510-0433 or scbusiness@myyahoo.com and one will be provided in writing.
This notice summarises rights created by the federal No Surprises Act (45 CFR 149.610). It is provided for information and is not legal advice.