Your Right to a Good Faith Estimate

If you do not have health insurance, or you choose not to use your insurance to pay for your care, you have the right to receive a Good Faith Estimate explaining how much your care is expected to cost. This right comes from the federal No Surprises Act.

• You have the right to receive a written Good Faith Estimate of the expected charges for your care when you schedule services or when you request one.
• If you schedule a session at least 3 business days in advance, you will generally receive your estimate within 1 business day after scheduling. If you schedule at least 10 business days in advance, you will receive it within 3 business days. If you request an estimate before scheduling, you will receive it within 3 business days.
• My per-session fee is listed on the insurance & fees page. Your Good Faith Estimate will show the expected services and estimated charges based on the frequency and duration of care reasonably anticipated at the time the estimate is prepared.
• If you receive a bill from me that is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.
• Keep a copy of your Good Faith Estimate for your records.

To request a Good Faith Estimate, email billing@mindfulsupportservices.com or call 425-640-7009, extension 2. The billing team at Mindful Support Services prepares estimates for my practice.

For questions about your rights or more information, visit cms.gov/nosurprises or call 1-800-985-3059.