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Legal

Your Right to a Good Faith Estimate

Under the federal No Surprises Act (effective January 1, 2022), you have the right to receive a Good Faith Estimate of expected charges.

Who is eligible

If you are uninsured or are not planning to submit your claim to insurance, you are entitled to receive a Good Faith Estimate of the expected charges for psychological services before your first appointment.

What it includes

  • The expected services and CPT codes
  • The expected fee per session
  • The clinician's name, NPI, and Tax ID
  • An estimate of the total expected cost based on the anticipated frequency of services

Disputes

If your final bill is at least $400 more than your Good Faith Estimate, you may dispute the bill through the federal Patient-Provider Dispute Resolution process within 120 days of receiving the bill.

How to request one

Email phdpamelabrown@gmail.com to request your Good Faith Estimate. You may also request one verbally at any time.

For more information visit www.cms.gov/nosurprises or call 1-800-985-3059.

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