No Surprises Act Notice

Right to Receive a Good Faith Estimate of Expected Charges

Under the No Surprises Act, you have the right to receive a “Good Faith Estimate” of expected charges for therapy services.

If you are a client without insurance, or if you choose not to use your insurance for therapy services, you are entitled to receive a Good Faith Estimate for the total expected cost of non-emergency therapy services. This includes any additional related costs that may arise.

You will receive your Good Faith Estimate in writing at least one business day before your first session or any other scheduled therapy services. If you request it, you can also receive a Good Faith Estimate before scheduling additional services.

In the event you receive a bill that is at least $400 more than the Good Faith Estimate, you have the right to dispute the charge.

Please make sure to save a copy or picture of your Good Faith Estimate for your records.

For more information about your rights under the No Surprises Act, visit www.cms.gov/nosurprises or call HHS at 1-800-958-3059.