Your Right to a Good Faith Estimate

Your Right to a Good Faith Estimate

You have the right to receive a "Good Faith Estimate" explaining how much your 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 and psychological evaluations.

• 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 sessions, evaluations, and any testing materials.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your service. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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.

Who Receives an Estimate

A Good Faith Estimate is for clients who are uninsured or who are not using insurance to pay for care ("self-pay"). Because this practice is out-of-network and clients pay privately, most people who work with Dr. Aday are entitled to a Good Faith Estimate.

What Your Estimate Includes

Your estimate reflects the charges we can reasonably expect for the care you are scheduling, such as the per-session fee, the number of sessions or the length of a program, and the cost of any evaluation, testing, or report. The estimate is based on the information known at the time it is prepared. It is not a bill, and actual costs may vary if your care changes.

When You Will Receive It

If you schedule a service at least 3 business days in advance, you will receive a written Good Faith Estimate within 1 business day of scheduling. If you schedule at least 10 business days in advance, you will receive it within 3 business days. You may also request an estimate at any time before scheduling, and you will receive it within 3 business days of your request.

This Estimate Is Not a Contract

A Good Faith Estimate shows the costs of items and services that are reasonably expected for your care. It does not require you to obtain any of the items or services from the providers or facilities identified in the estimate, and it is not a contract or a guarantee of your final charges.

Your Right to Dispute a Bill

If you are billed at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through the federal patient-provider dispute resolution (PPDR) process. You must start the dispute within 120 calendar days of the date on your original bill. Disputing a bill will not affect the quality of care you receive.

How to Ask a Question or Dispute a Bill

For questions about your estimate or your bill, contact our practice directly at reyna@reynaaday.com or (305) 435-7662. For questions or more information about your right to a Good Faith Estimate, or to start a dispute, visit www.cms.gov/nosurprises or call the Centers for Medicare & Medicaid Services at 1-800-985-3059.

Provider Information

Good Faith Estimates are issued by:

• Dr. Reyna Aday Psychotherapy
• 338 Minorca Avenue, Suite 202, Coral Gables, FL 33134
• Phone: (305) 435-7662 · Fax: (305) 876-3087
• Email: reyna@reynaaday.com