Good Faith Estimate

Original: August 10, 2021

Updated: June 15, 2025

YOU HAVE THE RIGHT TO RECEIVE A “GOOD FAITH ESTIMATE”:

Under the law, you have the right to receive a Good Faith Estimate explaining how much your medical or mental health care will cost in advance. Health care providers are required to provide this estimate if you do not have insurance or are not using insurance for your services.

WHAT IS INCLUDED:

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs such as:

  • Medical tests

  • Prescription drugs

  • Equipment

  • Hospital fees

  • Therapy and counseling services

TIMING OF THE GOOD FAITH ESTIMATE:

Your health care provider must give you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also request a Good Faith Estimate for any services you plan to schedule.

DISPUTING A BILL:

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

IMPORTANT INFORMATION:

Make sure to save a copy or picture of your Good Faith Estimate for reference.

For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

STATE-SPECIFIC CONSIDERATIONS

California:

Under the California Consumer Privacy Act (CCPA), if you request a Good Faith Estimate in the state of California, we are required to provide clear information about the total cost of services as part of your rights to transparency and pricing. As a licensed mental health provider in California, we are also obligated to provide accurate billing information under the California Mental Health Parity Act.

Texas:

In Texas, health care providers are required to give you a Good Faith Estimate before scheduling services that are not covered by insurance. Texas state law also supports your right to dispute any charges that exceed your Good Faith Estimate by $400 or more. If you need assistance with any billing disputes, we encourage you to contact the Texas Department of Insurance or your healthcare provider directly.

Florida:

Florida law also requires mental health providers to issue a Good Faith Estimate for non-emergency services. In Florida, the Florida Patient’s Bill of Rights ensures that individuals receive transparent pricing information for services rendered, especially when insurance is not used. If you receive a bill exceeding your Good Faith Estimate by $400 or more, Florida law provides a dispute resolution process. For more assistance, contact the Florida Agency for Health Care Administration (AHCA).

CONTACT US:

We welcome your questions or comments regarding the Good Faith Estimate.

Email Address: wellness@hellohealed.com