Good Faith Estimate

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Clients have the right to a Good Faith Estimate (GFE) if they are opting out of insurance or if they are paying for sessions out of pocket. This form may be used by the health care providers to inform individuals who are not enrolled in a plan or coverage or a Federal health care program (uninsured individuals), or individuals who are enrolled but not seeking to file a claim with their plan or coverage (self-pay individuals) of the expected charges they may be billed for receiving certain health care items and services.

  • The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service.
  • The estimate is based on information known at the time the estimate was created.
  • The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. 

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