GOOD FAITH ESTIMATE NOTICE
Right to a Good Faith Estimate
Under federal law (No Surprises Act), you have the right to receive a "Good Faith Estimate" of expected charges for psychotherapy services.
For Uninsured or Self-Pay Clients
If you are uninsured or choose not to use insurance, you may request a Good Faith Estimate of expected costs before beginning or scheduling services. This estimate will include:
Expected session fees
Frequency of services
Estimated duration of treatment (if applicable)
Accuracy of Estimate
The actual charges may differ from the Good Faith Estimate based on:
Changes in treatment needs
Length or complexity of services
Unforeseen clinical circumstances
Dispute Resolution
If you are billed $400 or more above your Good Faith Estimate, you have the right to dispute the bill through a federal process. For questions or to request a Good Faith Estimate, contact me at nicole.corlan@nicoletacorlan.com or (669) 282-0745.