Ember & Bloom Therapy Co, PLLC

Your Right to a Good Faith Estimate

Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining the expected cost of your medical and mental health care.

If you are not using insurance or plan to pay for services out-of-pocket, healthcare providers are required to provide an estimate of the expected charges for services.

You have the right to request a Good Faith Estimate before scheduling a service or at any time during your care.

Your estimate will include the anticipated costs of therapy sessions and any other related services provided by Ember & Bloom. Please note that the estimate is based on information available at the time and actual costs may vary depending on your individual needs and the course of treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

You may request a Good Faith Estimate at any time by contacting our office.

For more information about your rights under the No Surprises Act, visit:
https://www.cms.gov/nosurprises