Good Faith Estimate

Under federal law, health care providers must give clients who don't have insurance, or who are choosing not to use their insurance, an estimate of expected costs before treatment begins.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including psychotherapy services. This applies whether you're uninsured, self-pay, or choosing not to use insurance for these services.

  • You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or any time you request it.

  • If you receive a bill that's at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • Make sure to save a copy of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

What's Included in Your Estimate

Before your first session (or anytime you request one), you'll receive a written estimate that includes:

  • The services expected to be provided, including session type and frequency

  • The estimated cost per session

  • The estimated total cost over a 12-month period, based on the expected course of treatment

  • The name and NPI of the provider(s) involved

Your estimate is based on the information available at the time it's given, and on what's typical for a course of treatment like yours. Actual costs may differ if your needs change — for example, if you and your partner decide to increase session frequency, add a Weekend Intensive, or extend care beyond the initial estimate window.

A Few Things to Know

  • This estimate is not a contract and doesn't obligate you to receive any of the services listed.

  • Your estimate does not include any services that might be recommended during care but aren't yet scheduled — those would be provided in a separate estimate.

  • If your actual bill is $400 or more above your Good Faith Estimate, you have the right to dispute the charge through the U.S. Department of Health and Human Services' Patient-Provider Dispute Resolution process.

Request Your Estimate

If you're uninsured, self-pay, or choosing not to use insurance for these services, you'll receive a Good Faith Estimate before your first scheduled appointment — including your assessment session — based on a typical course of treatment for the service you're requesting.

Once we've completed a full assessment together, I'll provide an updated, personalized estimate reflecting the specific course of treatment we've discussed.

To request your Good Faith Estimate, write to connect@aspenconnections.com.