Your Right to a Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your mental health care will cost. Health care providers must give clients who are uninsured or who are not using insurance an estimate of the expected charges for services.

Your estimate will describe:

• The services expected — for example intake assessment, individual therapy, family therapy, or group sessions.
• The expected session length and frequency.
• The rate per session and the estimated total over the expected course of care.

You will receive a Good Faith Estimate in writing at least one business day before your scheduled service if you schedule at least three business days in advance, and within three business days of a request. You can also ask any provider for one before you schedule.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through the federal patient-provider dispute resolution process. Make sure to save a copy of your estimate.

Good Faith Estimates apply to clients who are uninsured or choosing not to use insurance. If you are using Medicaid, OhioRISE, or a managed care plan we accept, your costs are set by that plan — we verify your benefits before your first appointment and tell you about any copay or coinsurance up front.

Call (614) 706-6545 or email admin@servingyouthohio.org and ask for a Good Faith Estimate. For more information about your rights, visit www.cms.gov/nosurprises.