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Good Faith Estimate

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 No Surprises Act, health care providers must give patients who do not have insurance, or who are not using insurance, an estimate of the expected charges for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your service. You can also ask for one before you schedule.
  • 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.

Because Listen In Therapy PLLC is a self-pay practice, a Good Faith Estimate is provided to every client. Request one at any time by contacting info@listenintherapy.com.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.