You have the right to receive a Good Faith Estimate. Under federal law, healthcare providers must 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.
Your right to a Good Faith Estimate
Under Section 2799B-6 of the Public Health Service Act (the "No Surprises Act"), healthcare providers must give patients who are either uninsured or who choose not to use their insurance an estimate of the bill for medical items and services they are scheduled to receive.
What the GFE covers
Your Good Faith Estimate (GFE) will include the expected charges for the items and services you are scheduled to receive, including:
- Initial psychiatric evaluation and any associated diagnostic codes
- Anticipated follow-up visits over the next 12 months
- Anticipated medications you may be prescribed (note: dispensing and medication costs are billed by your pharmacy, not by us)
- Anticipated lab work or referrals (note: these are billed by the third-party lab or specialist, not by us)
- Cost per service expressed in U.S. dollars, along with the corresponding CPT/HCPCS billing code
How to request a Good Faith Estimate
- You will receive a GFE automatically if you schedule services at least 3 business days in advance and have told us you do not plan to use insurance.
- You can request a GFE at any time before scheduling. We will provide it within 3 business days of your request.
- The GFE will be provided in writing — by email, through the patient portal, or by mail, based on your preference.
To request a GFE, contact us through our contact form or email billing@valleyvistapsychiatry.com.
Important limits
- A GFE is an estimate only. The actual bill may differ if the services, time, or complexity change during the visit.
- A GFE does not obligate you to receive services — you may decide not to proceed based on the estimate.
- A GFE does not include charges from providers, labs, or pharmacies outside of our practice. Those entities are required to provide their own GFEs.
- A GFE is not a contract. It is a good-faith estimate of expected charges based on what we know at the time the estimate is prepared.
Disputing a bill
If you receive a final bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill through the federal Patient-Provider Dispute Resolution process. You must initiate the dispute within 120 calendar days of receiving the final bill.
To start a dispute or learn more, visit www.cms.gov/nosurprises or call 1-800-985-3059.
More information
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or contact:
Centers for Medicare & Medicaid Services
No Surprises Help Desk: 1-800-985-3059
Keep a copy of your Good Faith Estimate in a safe place. You may need it if you are billed a higher amount.