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Good Faith Estimate Notice

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 patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.  

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. 

 

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. 

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 

Ellen Garfield, LMFT #103425

Licensed Marriage and Family Therapist

Appointments available throughout the day and evening, Mondays–Thursdays

831-854-7543

6233 Soquel Drive Suite C. Aptos, CA 95003

Serving: Aptos, Watsonville, Santa Cruz, Scotts Valley, Felton, Ben Lomond, Boulder Creek, Capitola, Soquel, Aromas, Las Lomas, Castroville, Prunedale, Salinas, San Juan Bautista

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Good Faith Estimate Notice

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