Good Faith Estimate.
If you’d like to add information about the No Surprise Act and Good Faith Estimates, you can add it here. Below is a sample of what some therapists include. It is up to you to determine what documentation is needed. This is not to take the place of up-to-date legal advice from CMS or any other more legit source than me!
SAMPLE
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.
Starting in 2022, there are new protections that prevent surprise medical bills. If you’re uninsured or you decide not to use your health insurance for a service, under these protections, your health care provider needs to provide you with a good faith estimate of the cost of your care upfront, before your visit.
You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
You can dispute a medical bill if your final charges are at least $400 higher than your good faith estimate, and you file your dispute claim within 120 days of the date on your bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the Help Desk at 1-800-985-3059 for more information. TTY users can call 1-800-985-3059.