A Good Faith Estimate is a written summary of the expected costs for your medical or mental health services. Under the No Surprises Act, you have the right to receive this estimate if you are uninsured or choosing not to use your insurance.

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This estimate helps you understand potential costs before receiving care.

Applies to:

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• Patients without insurance

• Patients choosing self-pay

• Patients receiving services not covered by insurance (e.g., functional psychiatry, testing)

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Does NOT apply to:

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• Fully covered insurance visits (though costs like copays/deductibles still apply)

Your Good Faith Estimate will outline:

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• Type of service (evaluation, follow-up, etc.)

• Expected frequency of visits

• Estimated total cost of care

• Any additional recommended services (if applicable)