Good Faith Estimate

Your Right to Receive a Good Faith Estimate

Under federal law, individuals who do not have health insurance or who choose not to use their health insurance to pay for care generally have the right to receive a Good Faith Estimate explaining the expected cost of scheduled health care services.

If you are uninsured or self-pay, you may ask Vela Women’s Mental Health for a Good Faith Estimate before scheduling a service or at any time before receiving care.

The estimate will include the expected charges for the services reasonably anticipated as part of your treatment.

A Good Faith Estimate is an estimate, not a contract. The length and frequency of psychotherapy can vary depending on your individual needs, preferences, and treatment goals.

If your bill is substantially higher than your estimate

Federal law provides a patient-provider dispute resolution process in certain circumstances when the amount billed is at least $400 more than the amount listed on the Good Faith Estimate.

You may also contact Vela Women’s Mental Health to discuss any questions regarding your bill or estimate.

Keep a copy or photograph of your Good Faith Estimate for your records.

For additional information about your rights under the No Surprises Act, visit the Centers for Medicare & Medicaid Services website.