Good Faith Estimate

Effective January 1, 2022, a ruling went into effect called the "No Surprises Act" which requires practitioners to provide a "Good Faith Estimate". The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for therapy. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new "Good Faith Estimate" should this occur. If this happens, federal law allows you to dispute (appeal) the bill if you and your therapist have not previously talked about the change and you have not been given an updated good faith estimate.  

Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request, or at the time of scheduling health care items and services to receive a "Good Faith Estimate" of expected charges. 

Note: The PHSA and GFE does not currently apply to any clients who are using insurance benefits, including "out of network benefits'' (i.e.., submitting superbills to insurance for reimbursement). 

Under the law, health care providers need to 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. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. 

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. 

At Flourish Center for Cultivating Human Potential, upon intake, you may ask to receive an individualized Good Faith Estimate Form which will estimate your cost for therapy for the year, depending on the agreed-upon and pre-determined rate. 

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

The provider may recommend additional items or services as part of the treatment that are not reflected in the estimate. These would need to be scheduled separately. 

The information provided in the Good Faith Estimate is only an estimate, as actual items, services, or charges may differ. 

The client has the right to engage in a dispute resolution process if the actual costs of services significantly exceed those listed in the Good Faith Estimate. 

The Good Faith Estimate does not obligate or require the client to obtain any of the listed services from the provider.

For questions or more information about your right to a Good Faith Estimate, visit: https://www.cms.gov/nosurprises. 

Flourish Center For Cultivating Human Potential – 328 E. Main Street, Spring Arbor MI 49283

517-435-4101

Engage@flourishhumanity.com