
Good Faith Estimate

- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care organization gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care organization, and any other organization you choose, for a Good Faith Estimate before you schedule an item or service.
- Evergreen Counseling provides session and service fees in our initial intake documentation with clients who are private pay which clients must sign before their first session.
- 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.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.