Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.
Under federal law, health care providers must give patients who do not have certain types of health coverage, or who are not using certain types of health coverage, an estimate of expected charges for health care items and services before those items or services are provided.
You have the right to receive a Good Faith Estimate for the total expected cost of your care upon request or when scheduling services.
If you schedule care 3–9 business days in advance, NWPS must provide the Good Faith Estimate in writing within 1 business day after scheduling.
If you schedule care 10 or more business days in advance, NWPS must provide the Good Faith Estimate in writing within 3 business days after scheduling.
You may also request a Good Faith Estimate before scheduling. NWPS must provide it within 3 business days after the request.
If a bill from NWPS is at least $400 more than the amount listed on the Good Faith Estimate from NWPS, you may be able to use the federal patient-provider dispute resolution process.
Who this applies to
These rights generally apply if you do not have health coverage, or if you have private health insurance or Federal Employees Health Benefits coverage but are not seeking to have a claim submitted for your NWPS services.
They generally do not apply if you are enrolled in Medicare, Medi-Cal, TRICARE, or another federal health care program.
Requesting an estimate
To request a Good Faith Estimate from Nick Welsh Psychiatric Services, contact office@nickwelshmd.com.
For more information about your rights, visit cms.gov/medical-bill-rights or call the No Surprises Help Desk at 1-800-985-3059.