Good Faith Estimate Notice
Under Section 2799B-6 of the Public Health Service Act (No Surprise Act), health care providers are required to provide clients who are uninsured or self-pay with a Good Faith Estimate of the expected charges for services.
Your Right to a Good Faith Estimate
If you do not have insurance or choose not to use insurance, you have the right to receive a Good Faith Estimate explaining how much your mental health care will cost.
This estimate will include the expected cost of therapy services and is provided before services are rendered, or upon request.
Dispute Resolution
If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill through the U.S. Department of Health and Human Services.
More information about your rights is available at:
cms.gov/nosurprises
or by calling:
1-800-985-3059.
Questions
If you have questions about your Good Faith Estimate or therapy fees, please contact our office directly.
Under Section 2799B-6 of the Public Health Service Act (No Surprise Act), health care providers are required to provide clients who are uninsured or self-pay with a Good Faith Estimate of the expected charges for services.
Your Right to a Good Faith Estimate
If you do not have insurance or choose not to use insurance, you have the right to receive a Good Faith Estimate explaining how much your mental health care will cost.
This estimate will include the expected cost of therapy services and is provided before services are rendered, or upon request.
Dispute Resolution
If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill through the U.S. Department of Health and Human Services.
More information about your rights is available at:
cms.gov/nosurprises
or by calling:
1-800-985-3059.
Questions
If you have questions about your Good Faith Estimate or therapy fees, please contact our office directly.
Resources
DBSAWV - Depression and Bipolar Support Alliance
Resources For Monongalia County Families and Children
NATIONAL RESOURCES:
National Crisis Lifeline - Call or Text 988
Mental Health:
Crisis Text Line - Text HELLO to 741741
(Persons of color - text STEVE to same #)
(Eating or body concerns - text NEDA)
www.crisistextline.org
National Youth Crisis Hotline
1-800-448-4663
Suicide:
National Suicide Prevention Lifeline
Call or Text 988
www.988lifeline.org
Veteran’s Crisis Line
1-800-273-8255 press 1
www.veteranscrisisline.net
Trevor Project (LGBTQIA+ suicide prevention)
866-488-7386
www.thetrevorproject.org
Alcohol & Other Drugs:
Crisis Text Line
www.crisistextline.org
SAMHSA’s National Helpline
1-800-662-HELP (4357)
Sexual Assault & Relationship Violence:
RAINN National Sexual Assault Hotline
1-800-656-HOPE (4673)
www.rainn.org
National Teen Dating Abuse Helpline
1-866-331-9474 / Text “START” to 88788
www.thehotline.org
National Crisis Lifeline - Call or Text 988
Mental Health:
Crisis Text Line - Text HELLO to 741741
(Persons of color - text STEVE to same #)
(Eating or body concerns - text NEDA)
www.crisistextline.org
National Youth Crisis Hotline
1-800-448-4663
Suicide:
National Suicide Prevention Lifeline
Call or Text 988
www.988lifeline.org
Veteran’s Crisis Line
1-800-273-8255 press 1
www.veteranscrisisline.net
Trevor Project (LGBTQIA+ suicide prevention)
866-488-7386
www.thetrevorproject.org
Alcohol & Other Drugs:
Crisis Text Line
www.crisistextline.org
SAMHSA’s National Helpline
1-800-662-HELP (4357)
Sexual Assault & Relationship Violence:
RAINN National Sexual Assault Hotline
1-800-656-HOPE (4673)
www.rainn.org
National Teen Dating Abuse Helpline
1-866-331-9474 / Text “START” to 88788
www.thehotline.org