Good Faith Estimates & Your Rights Under the No Surprises Act

A Good Faith Estimate is a written estimate of the expected costs for healthcare services.

It is intended to help you understand the anticipated cost of treatment before services begin so you can make informed decisions about your care.

The estimate is based on information known at the time it is prepared and is not a contract or guarantee of the final cost of services.

You may request a Good Faith Estimate if you:

• Do not have health insurance.

• Choose not to use your health insurance for covered services.

• Are paying for services out of pocket.

If you plan to use your insurance benefits, a Good Faith Estimate may not apply in the same way because your financial responsibility depends on your specific insurance plan and benefits.

A Good Faith Estimate may include:

• The expected cost of your initial appointment.

• Estimated fees for ongoing therapy sessions.

• Other reasonably anticipated charges related to your care, if applicable.

Because therapy is individualized, the total number of sessions and overall cost of treatment cannot always be predicted in advance.

Under federal law, you have the right to:

• Receive a Good Faith Estimate before scheduled services when applicable.

• Ask questions about the estimated costs of care.

• Request clarification if you do not understand your estimate.

• Dispute certain medical bills if the final charges substantially exceed your Good Faith Estimate, consistent with applicable federal law.

Additional information about your rights under the No Surprises Act is available from the Centers for Medicare & Medicaid Services (CMS).

If you believe you are eligible for a Good Faith Estimate or would like additional information, please contact our office before your first appointment.

We are happy to answer questions about our fees, payment options, and the estimated cost of beginning therapy.

Current information regarding:

• Session fees

• Accepted insurance plans

• Private-pay services

• Out-of-network reimbursement

• Payment policies

is available on our Cost & Insurance page.

We encourage you to review that page or contact us if you have questions about the cost of services.

If you have questions regarding Good Faith Estimates or your financial responsibilities, please contact:

Create & Connect Art Therapy and Counseling

Email: office@candcarttherapy.com

Phone: 240-253-9788

Website: https://www.candcarttherapy.com