Under the No Surprises Act, health care providers are required to provide clients who are uninsured or not using insurance with a Good Faith Estimate of the expected costs of services.

You have the right to receive a written Good Faith Estimate outlining the total expected cost of non-emergency mental health services, including psychotherapy sessions and related services.

You may request a Good Faith Estimate:

• Before scheduling services, or

• At least one business day before your scheduled appointment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the charges.

We encourage you to keep a copy of your Good Faith Estimate for your records.

For more information about your rights under the No Surprises Act, visit the Centers for Medicare & Medicaid Services at:

www.cms.gov/nosurprises

or

call 1-800-985-3059.

If you have questions about fees or payment options at Vida Wellness and Counseling Services, please contact us directly.