Your Right to a Good Faith Estimate

Under the No Surprises Act

You have the right to receive a "Good Faith Estimate" explaining how much your medical and mental-health care will cost.

Under the law, health-care providers need to give patients who don't have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including psychotherapy.
• You will receive a Good Faith Estimate automatically when you schedule a service (at least 1 business day before the service, or within 3 business days for services scheduled further out) — and you can also ask for one at any time before scheduling.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through the federal patient-provider dispute-resolution process within 120 days of the bill's date.
• Make sure to save a copy of your Good Faith Estimate.

To request a Good Faith Estimate, contact info@katelinhanhart.com. For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.

This notice is provided to comply with the No Surprises Act and is for informational purposes.