Good Faith Statement

for Non-Insurance Clients

Under the law, health care providers are required to give patients not using insurance, an estimate of the expected charges for medical services, including psychotherapy services. 
 
As a client paying out of pocket, you have the right to receive a Good Faith Estimate, defining the total expected cost of any non-emergency healthcare services, including psychotherapy services.
 
You can ask your healthcare provider, and any other provider you choose, for this Good Faith Estimate before you scheduling a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
 
For questions or more infor on your rights to a Good Faith Estimate, please visit CMS.gov/nosurprises.