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Good Faith Estimate & No Surprises Act

Information about your right to receive a Good Faith Estimate of expected charges under the federal No Surprises Act.

Note: The general rights described below reflect the federal No Surprises Act. The practice-specific details (how to request an estimate, timelines, and contact information) should be reviewed for accuracy before publishing.

Your right to a Good Faith Estimate

Under the law, health care providers need to give patients who don't have certain types of health insurance, or who are not using certain types of health insurance, an estimate of expected charges for services, including psychotherapy services.

  • You have the right to receive a Good Faith Estimate of what your care may cost.
  • You can request a Good Faith Estimate before you schedule a service, or at any time during care.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
  • Keep a copy of your Good Faith Estimate for your records.

How to request an estimate from Heart 2 Soul Counseling

Insert the practice's actual process for requesting a Good Faith Estimate (who to contact, expected turnaround time, and format provided).

More information

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

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