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Federal Law

Good Faith Estimate Notice

In compliance with the No Surprises Act (42 U.S.C. § 300gg-111) | TheraPeace PLLC

Your Right to a Good Faith Estimate

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 bill for medical items and services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychotherapy sessions, assessments, and related services provided by TheraPeace PLLC.

What This Means for You

  • You have the right to receive a written Good Faith Estimate before your service begins.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your scheduled service.
  • You can also ask your health care provider for a Good Faith Estimate before you schedule a service.
  • 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.

Requesting Your Estimate

To request a written Good Faith Estimate before your first appointment or at any time, please contact us:

TheraPeace PLLC

Phone: 704-806-0015

Email: therapeacepllc@gmail.com

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

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