GOOD FAITH ESTIMATE & NO SURPRISES ACT NOTICE

Your Right to Receive a Good Faith Estimate

If you do not have health insurance or you choose not to use your insurance to pay for services, you generally have the right to receive a Good Faith Estimate of expected charges before receiving services.

CMS explains that providers generally must provide a Good Faith Estimate when an uninsured or self-pay individual schedules care sufficiently in advance or requests an estimate. 

What Is a Good Faith Estimate?

A Good Faith Estimate provides an itemized estimate of expected charges for services that Vermillion Skies reasonably expects to provide.

It is an estimate, not a guarantee of the final amount you will owe.

Actual services may vary depending on clinical needs, scheduling, treatment frequency, changes in treatment goals, or other circumstances.

Requesting an Estimate

You may request a Good Faith Estimate by contacting:

Vermillion Skies Mental Health
[Phone]
[Email]

If you schedule services in advance and are uninsured or self-pay, we will provide an estimate within the applicable federal timeframe.

Your Right to Dispute a Bill

If you are eligible under federal law and your final bill is at least $400 more than the Good Faith Estimate provided for that provider or facility, you may be eligible to use the federal patient-provider dispute resolution process. CMS currently identifies this $400 threshold as part of the eligibility requirements. 

You should retain your Good Faith Estimate and compare it with your final bill.

For current information about the federal dispute process please click this link to view the most up to date information on the CMS.gov website