Good Faith Estimate

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining how much your mental health care will cost.

What This Means for You

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 and psychological evaluation services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

At Complete Family Services, Inc.

Because Complete Family Services, Inc. operates as a private-pay practice and is not in-network with any insurance company, the Good Faith Estimate provisions apply to all clients who do not plan to submit claims for insurance reimbursement.

For specific cost information regarding evaluations, therapy sessions, parent consultation, or forensic services, please contact us directly at (310) 375-8665 or complete our contact form. We will provide a written Good Faith Estimate before or at the time services are scheduled.

What's Included in Your Estimate

Your Good Faith Estimate will include:

• Anticipated cost per session or per evaluation
• Anticipated number of sessions or hours of testing (where applicable)
• Any related services or fees

Your Rights

• You have the right to receive a Good Faith Estimate before scheduling a service.
• You have the right to receive your estimate in writing at least 1 business day before your scheduled service, or at the time of scheduling if the service is scheduled at least 3 business days in advance.
• You have the right to dispute a bill that is at least $400 more than your Good Faith Estimate.

Disputing a Bill

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through the patient-provider dispute resolution process.

For more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call (800) 985-3059.

Questions?