Good Faith Estimate
Your Right to a Good Faith Estimate (GFE) of Costs
Federal law (the No Surprises Act) gives patients who are uninsured or not using insurance the right to an estimate of charges before receiving non-emergency care.
What this means for you
- You can receive a written Good Faith Estimate outlining the expected total cost of non-emergency items and services. When applicable, this may include related charges (e.g., associated services or fees).
- We will provide your Good Faith Estimate in writing at least 1 business day before your scheduled service. You can also request an estimate before you decide to schedule.
- If your final bill is $400 or more above the Good Faith Estimate, you have the right to dispute the bill.
- Please save a copy or photo of your Good Faith Estimate for your records.
A Good Faith Estimate is based on information known at the time and is not a contract or a guarantee of final charges. Your actual costs may vary if your treatment plan changes.
Questions or more information: For questions or more information about your right to a Good Faith Estimate, visit http://www.cms.gov/nosurprises or call 800-985-3059.
Practice contact: For questions about estimates or billing at New Horizons Behavioral Health, PLLC, please contact NHBH Billing Administrator at (931) 551-8744.