Good Faith Estimate & Your Rights

Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining the expected cost of your healthcare services if you are uninsured or choose not to use your health insurance.

At Elizabeth Redwine Therapy Services, PLLC, I believe in transparency regarding the cost of therapy.

What is a Good Faith Estimate?

A Good Faith Estimate is a written estimate of the expected charges for healthcare services you may receive. It is intended to help you understand the anticipated cost of your care before services are provided.

Who is eligible?

You may be eligible for a Good Faith Estimate if:

• You do not have health insurance.

• You have health insurance but choose not to use it for your therapy services.

If you plan to use your insurance benefits, your estimated out-of-pocket responsibility will depend on your individual insurance coverage, deductible, copayment, coinsurance, and other plan requirements.

Your Rights

• You have the right to receive a Good Faith Estimate before scheduling services or upon request.

• You have the right to receive an estimate of expected charges for services.

• You are not required to schedule services after receiving an estimate.

• You may ask questions about the estimated cost of your care.

What if my bill is higher than my estimate?

If you are uninsured or choose not to use insurance and your bill from a provider is at least $400 more than your Good Faith Estimate for the services provided by that provider, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.

You generally have 120 calendar days from the date of the original bill to initiate a dispute.

For additional information, visit:

https://www.cms.gov/nosurprises

Requesting an Estimate

To request a Good Faith Estimate or discuss fees and payment options, please contact:

Elizabeth Redwine Therapy Services, PLLC

Email: [email protected]

You may also request an estimate when arranging services through Sessions Health.

A Good Faith Estimate is an estimate of expected charges and is not a contract or guarantee of the final cost of services.