Good Faith Estimate

Who this is for

Under the federal No Surprises Act, health care providers must give people who do not have insurance, or who have insurance but are choosing not to use it, an estimate of what their care will cost before it starts. That applies to counseling as much as to any other kind of care.

If you are using insurance, this is not the document you need — what you will pay depends on your plan, and we will help you work that out. See Rates & Insurance, or call us and we will check your benefits with you at no charge.

What you are entitled to

1. A Good Faith Estimate in writing, covering the total expected cost of any non-emergency service, including any related costs.
2. An estimate before you schedule, if you ask for one. You can ask us, and any other provider you are considering, and compare.
3. The right to dispute the bill if what you are charged is at least $400 more than your estimate.

When we will give you one

• If you schedule at least 3 business days ahead, you will have your estimate within 1 business day of scheduling.
• If you schedule at least 10 business days ahead, within 3 business days of scheduling.
• If you simply ask for one without scheduling, within 3 business days of asking.

Keep a copy or a photograph of it. You will need it if you ever want to dispute a bill.

What counseling estimates look like

Therapy is not a single procedure with a single price, so an estimate for counseling is built from the rate for each session and the number of sessions we expect at the outset. That is a genuine estimate, not a commitment you are locked into — how long you come, and how often, stays your decision, and we will talk about it as we go.

If the plan changes substantially, ask us for an updated estimate. We would rather you had a current one than a stale one.

How to ask for one

Call 817-778-9232, or say so when you request an appointment. There is no charge for an estimate and no obligation to book after you have seen it.

If you want to dispute a bill

If you are billed at least $400 more than your Good Faith Estimate, you can start a patient-provider dispute resolution process with the U.S. Department of Health and Human Services. You have 120 days from the date of the bill to begin.

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