Effective Date: May 10, 2026
Your Right to a Good Faith Estimate
Under the federal No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining how much your mental health care will cost.
Who This Applies To
You have the right to receive a Good Faith Estimate from Balanced Mind Mental Health if you are:
- Uninsured (you do not have health insurance), OR
- Insured but choosing not to use your insurance (self-pay)
What The Estimate Includes
Your Good Faith Estimate will include the expected charges for psychiatric and mental health services you schedule with us, including evaluation, therapy sessions, medication management, and any other services we plan to provide.
When You Will Receive It
You can request a Good Faith Estimate at any time before scheduling a service. We will provide it in writing within the timeframes required by federal law:
- If you schedule a service at least 10 business days in advance: you will receive the estimate at least 3 business days before your appointment.
- If you schedule a service at least 3 business days in advance: you will receive the estimate within 1 business day of scheduling.
- You can also request an estimate before scheduling.
Your Right To Dispute
If you receive a final bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through the federal patient-provider dispute resolution process.
What To Do
- Save a copy of your Good Faith Estimate for your records.
- Ask us if you have any questions about your estimate.
- Make sure your estimate is in writing.
Learn More
For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
