Good Faith Estimate

Under the federal No Surprises Act, health care providers must give people who are uninsured or who are not using insurance an estimate of the expected charges for medical and mental health services, including psychological and neuropsychological evaluations and therapy.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including evaluation, testing, feedback, and report preparation.
• You can ask Encore Psychology for a Good Faith Estimate before you schedule a service, or at any time during treatment.
• If you schedule a service at least three business days in advance, we will provide a Good Faith Estimate in writing within the timeframe required by law.
• Make sure to save a copy of your Good Faith Estimate.

If you receive a bill that is at least $400 more than your Good Faith Estimate for any single provider, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process. Disputing a bill does not affect the quality of care you receive.

Contact our reception team and we will prepare an estimate specific to the evaluation or service you are considering.

Encore Psychology
33 Bloomfield Hills Parkway, Suite 225, Bloomfield Hills, MI 48304

• Phone: (248) 452-6669
• Email: admin@encorepsychology.com

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059.