Your Right to a Good Faith Estimate
Trinity Holistic Psychiatry
Under the federal No Surprises Act, individuals who do not have health insurance or who choose not to use their health insurance to pay for care generally have the right to receive a Good Faith Estimate of the expected cost of their care before services are provided.
Who Can Receive a Good Faith Estimate?
You may be entitled to receive a Good Faith Estimate if you:
● Do not have health insurance; or
● Have health insurance but do not plan to use your insurance to pay for your care. Your Right to an Estimate
You have the right to receive a Good Faith Estimate explaining how much your health care is expected to cost.
If you schedule care at least 3 business days in advance, you generally have the right to receive a Good Faith Estimate before your scheduled service.
You may also request a Good Faith Estimate before scheduling an appointment.
If you have questions about the cost of services, you may ask Trinity Holistic Psychiatry for a Good Faith Estimate.
What Is a Good Faith Estimate?
A Good Faith Estimate provides the expected charges for health care items or services that are reasonably expected to be provided based on the information available when the estimate is prepared.
The estimate is not a bill or a contract, and it does not require you to receive the listed services from Trinity Holistic Psychiatry.
Your actual treatment needs may change, and additional or different services may be recommended or requested that were not reasonably anticipated when the estimate was prepared.
What If My Bill Is Higher Than My Good Faith Estimate?
If you receive a bill from a provider or facility that is at least $400 more than the amount listed on the Good Faith Estimate from that provider or facility, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process.
A dispute generally must be initiated within 120 days of receiving the initial bill. Initiating a dispute will not adversely affect the quality of health care services you receive. Keep a copy of your Good Faith Estimate so you can compare it with any bills you receive. For more information about Good Faith Estimates and your rights under the No Surprises Act: CMS – Good Faith Estimates and Your Medical Bill Rights
Request a Good Faith Estimate
To request a Good Faith Estimate or ask questions about expected charges, please contact:
Trinity Holistic Psychiatry
Phone: 916-610-9401