Your Right to a
Good Faith Estimate

Under federal law, health care providers must give individuals who do not have insurance or who are not using insurance an estimate of the expected charges for health care items and services.

Wholeness Psychotherapy provides Good Faith Estimates to self-pay clients for anticipated psychotherapy services. Your individualized estimate will be based on the information available at the time of scheduling and is not a contract for services.

You have the right to receive a Good Faith Estimate in writing at least one business day before a scheduled service. You may also request a Good Faith Estimate before scheduling a service.

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

For questions or to request an estimate, please contact:

Wholeness Psychotherapy
hello@wholenesspsychotherapy.com

For more information about your rights, visit cms.gov/nosurprises or call 1-800-633-4227.