No Surprises Act & Good Faith Estimate Notice

No Surprises Act & 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 additional information you can also visit www.cms.gov/nosurprises/Ending-Surprise-Medical-Bills or call 1 800 985 3059.

For information about your rights under Washington State law visit their website at: https://app.leg.wa.gov/wac/default.aspx?cite=284-43B-020

For questions or more information about your right to a Good Faith Estimate please contact the Antioch Clinic at 206 268-4840/Email: [email protected].