GOOD FAITH ESTIMATE

Under the No Surprises Act, you have the right to receive a Good Faith Estimate (GFE) explaining how much your therapy will cost before your care begins.

This ensures complete financial transparency with no unexpected bills.

• l  You are entitled to a GFE if you are uninsured, or if you are choosing to pay privately (self-pay) without using insurance.

• l  A GFE is a written tool for your financial planning. It outlines the expected costs of your sessions based on the care plan we discuss. It is an estimate, not a contract.

• l  You will receive your written estimate shortly after scheduling your first appointment, or within 3 business days of requesting one.

• l  If you receive a final bill that is at least $400 higher than your Good Faith Estimate, the law gives you the right to dispute the bill. You must initiate this dispute process within 120 days of the invoice date.

If you have any questions about session rates, frequency, or your estimate, please feel free to reach out.

For questions or more information about your right to a Good Faith Estimate, you can visit www.cms.gov/nosurprises or call the No Surprises Help Desk at 1-800-985-3059.

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