Good Faith Estimate & No Surprises Act

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, individuals who are uninsured or who choose not to use their health insurance have the right to receive a Good Faith Estimate (GFE) of the expected cost of scheduled health care services. A Good Faith Estimate provides an estimate of the charges for services that are reasonably expected based on the information available at the time the estimate is prepared. It is not a bill or a guarantee of the final cost of services.

When will I receive my Good Faith Estimate?

If services are scheduled 10 or more business days in advance, the estimate will be provided within 3 business days of scheduling. If services are scheduled 3–9 business days in advance, the estimate will be provided within 1 business day of scheduling. If you request an estimate without scheduling services, the estimate will generally be provided within 3 business days of your request.

What if my actual bill is higher than my estimate?

If you are uninsured or choose not to use insurance and your final bill is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal Patient-Provider Dispute Resolution process. You must begin the dispute process within 120 calendar days of receiving the initial bill and a $25 administrative fee may apply.

For more information about your rights, Good Faith Estimates, or the federal dispute process, visit the Centers for Medicare & Medicaid Services, CMS No Surprises Act: https://www.cms.gov/nosurprises You may also contact CMS at 1-800-985-3059.

We recommend keeping a copy of your Good Faith Estimate and comparing it with your final bill. Questions about your Good Faith Estimate? Please contact Therapeutic Healing Solutions at 979-202-1937 or marniec@therapyhs.com.

*Good Faith Estimates are based on services reasonably expected at the time the estimate is prepared. Actual services and charges may change if your needs or circumstances change.