Good Faith Estimate Notice

Under the No Surprises Act (Section 2799B-6 of the Public Health Service Act), you have the right to receive a Good Faith Estimate explaining the expected costs of your mental health care.

Your Right to a Good Faith Estimate

You have the right to receive a Good Faith Estimate (GFE) for the total expected cost of any non-emergency items or services. This includes the cost of therapy sessions, assessments, or other services provided by me, even if you don’t plan to use insurance or if you’re paying out of pocket.

You can request a Good Faith Estimate before scheduling a service or at any time during your care.

What Is Included in a Good Faith Estimate

Your GFE will include:

• The estimated cost of each service or session

• The frequency and duration of sessions (if known)

• Any potential additional fees related to treatment (if applicable)

The actual cost of services may vary depending on your individual needs, goals, and treatment plan. If your charges are more than $400 above the estimate, you have the right to dispute the bill.

How to Request Your Estimate

You will receive a written Good Faith Estimate upon scheduling your first appointment or at your request.
To request one, please contact me at:

📧 kscheib@hopefulhortizontherapy.org
📞 570-781-5899

Additional Information

This Good Faith Estimate does not obligate you to receive services from me and does not serve as a contract for therapy. It is simply meant to provide transparency about potential costs so you can make informed decisions about your care.

For more information about your right to a Good Faith Estimate, visit:
https://www.cms.gov/nosurprises