YOUR RIGHT TO A GOOD FAITH ESTIMATE
YOUR RIGHT TO KNOW THE EXPECTED COST OF YOUR CARE
Under federal law, healthcare providers generally must provide individuals who do not have health insurance or who are not using insurance to pay for their healthcare services with a Good Faith Estimate of expected charges under applicable circumstances.
A Good Faith Estimate can help you understand the expected cost of your healthcare before receiving services.
This notice applies to clinical therapy services. ADHD coaching, consulting, training, professional education, and LISW-S training supervision offered through Mindful Misfits are separate from psychotherapy and other healthcare services and have separate pricing and payment terms.
WHEN YOU MAY RECEIVE A GOOD FAITH ESTIMATE
If you are uninsured or do not intend to use insurance to pay for your therapy services, you have the right to receive a Good Faith Estimate explaining the expected charges for your care.
You may also request a Good Faith Estimate before scheduling a healthcare service.
If you schedule a healthcare service 3–9 business days in advance, the Good Faith Estimate generally must be provided within 1 business day after scheduling.
If you schedule a healthcare service 10 or more business days in advance, the Good Faith Estimate generally must be provided within 3 business days after scheduling.
If you request a Good Faith Estimate before scheduling a healthcare service, the estimate generally must be provided within 3 business days after your request.
WHAT YOUR ESTIMATE WILL INCLUDE
Your Good Faith Estimate will include the expected charges for healthcare services that are reasonably anticipated based on the information available at the time the estimate is prepared.
For ongoing psychotherapy, the exact length and frequency of treatment cannot always be predicted in advance.
Your estimate may therefore be based on the anticipated frequency of services over a specified period of time.
Your treatment needs may change, and you and your clinician may discuss changes to the frequency, duration, or type of services as treatment progresses.
A Good Faith Estimate is not a contract and does not require you to receive the services listed in the estimate.
IF YOUR BILL IS HIGHER THAN YOUR ESTIMATE
RECEIVING YOUR INDIVIDUAL ESTIMATE
If the billed charges from a healthcare provider are at least $400 more than the amount listed on that provider's Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process.
You may also contact your healthcare provider if you have questions about a bill or believe it differs from your Good Faith Estimate.
Keep a copy or photograph of your Good Faith Estimate for your records.
Good Faith Estimates are provided through the clinical processes used by your treating clinician.
Questions regarding the cost of therapy services or any applicable Good Faith Estimate should be directed through the appropriate clinician or clinical practice.
ADHD COACHING, CONSULTING, TRAINING & SUPERVISION
ADHD coaching, consulting, training, professional education, and LISW-S training supervision offered through Mindful Misfits are separate from psychotherapy and other healthcare services.
Pricing, packages, cancellation policies, payment requirements, and other financial terms for these services are provided separately through Mindful Misfits.
QUESTIONS ABOUT YOUR RIGHTS
Additional information about Good Faith Estimates and your rights under the No Surprises Act is available through the Centers for Medicare & Medicaid Services (CMS).
CMS — Good Faith Estimate Information: https://www.cms.gov/initiatives/your-patient-rights/medical-bill-rights/get-help/medical-bill-guides-resources/what-good-faith-health-insurance-estimate
CONTACT US
Questions regarding this Privacy Policy or our privacy practices may be directed to:
Mindful Misfits ADHD Coaching and Consultation LLC
Last Updated: August 27, 2028
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