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Good Faith Estimate

If you are uninsured or are a client who does private pay, meaning you pay for services yourself, you have the right to receive a “Good Faith Estimate”. A Good Faith Estimate is a document explaining how much your care or medical services will cost. At Rise Counseling and Coaching LLC, all clients will receive a client specific Good Faith Estimate as a part of your client paperwork prior to any fees being charged or services being started. 


Under the law, and according to the No Surprises Act, health care providers need to give patients who don’t have insurance or who are not using insurance  an estimate of the bill for medical items and services.


  • 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, mental health services, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical services or item. 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.

  • You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available..

  • There is a $25 fee to use the dispute process. If the Selected Dispute Resolution (SDR) entity reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate, reduced by the $25 fee. If the SDR entity disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

  • 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 or call 800-985-3059.

NOTE: A Good Faith Estimate is for your awareness only and does not require any sort of immediate "all at once" financial commitment or payment. You will only be billed for the appointments you make either for services you receive and/or any acquired no show/late cancel fees for scheduled appointments if applicable. 

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