Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, you have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give clients who do not have insurance, or are not using insurance, an estimate of their expected charges for medical services and items, including psychotherapy services.

You can ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule a session. The Good Faith Estimate shows the costs of items and services that are reasonably expected for your healthcare needs for an item or service. The estimate is based on information known at the time the estimate is created.

If you are paying privately, out-of-pocket, or using out-of-network reimbursement, New Brunswick Therapy will send you a Good Faith Estimate in writing no later than 1 business day before your first appointment.

If you receive a bill that is at least $400.00 USD more than your Good Faith Estimate, you can dispute the bill. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during the course of care. You could be charged more if special circumstances occur. In non-emergency circumstances, you will be provided with an updated Good Faith Estimate for any new expected charges.

You may contact the healthcare provider or New Brunswick Therapy to let them/us know the billed charges are higher than the Good Faith Estimate. You can ask us to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute within 120 calendar days (about 4 months) of the date of the original bill. There is a $25.00 USD fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on the Good Faith Estimate. If the agency disagrees with you and agrees with the healthcare provider or facility, you will have to pay the higher amount.

Make sure to keep a copy of your Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.

To learn more about your right to a Good Faith Estimate or to get a form to start the dispute resolution process, go to www.cms.gov/nosuprises or call (800) 368-1019.