Good Faith Estimate Notice

You have the right to know the cost of your care in advance. If you do not use insurance for your psychotherapy services, you may request a Good Faith Estimate of expected charges.

Your Rights

  • Request an Estimate Before You Schedule
    You may ask me—or any other provider you choose—for a Good Faith Estimate of the total cost of non‑emergency mental health services, including psychotherapy.
  • Receive a Clear Breakdown
    Your Good Faith Estimate will outline the anticipated fees for each service, so you can make informed decisions.
  • Dispute Unexpected Charges
    If your final bill is $400 or more above your Good Faith Estimate, you may dispute the charges. Retain your written or electronic estimate as proof.

For more information about your rights and how to dispute a bill, please visit:
www.cms.gov/nosurprises

If you have any questions or would like to request your Good Faith Estimate, please contact me at:

Heidi Elias, LCSW, SEP
info@heidielias.com
(646) 828-6300