Your Right to a Good Faith Estimate

Under the federal No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining how much your medical or mental health care will cost if you are not using insurance.

What This Means

If you are:

Uninsured, or
Not using insurance benefits

You have the right to receive a written estimate of expected charges before services begin.

This estimate will include:

Session fees
Frequency of sessions (if known)
Any additional anticipated costs

Important Information

The Good Faith Estimate shows the costs of services reasonably expected at the time the estimate is provided.
Actual charges may differ if your treatment needs change.
You may request an updated estimate at any time.

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

For questions about your rights, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Kindful Place Therapy Center is committed to transparent and ethical fee practices.