Good Faith Estimate
Under the federal No Surprises Act, and similar state-level protections in Colorado, healthcare providers—including mental health practitioners—must give a Good Faith Estimate (GFE) to patients who are uninsured or who choose not to use their insurance benefits. This estimate provides a clear, upfront look at the expected costs of their care. This information is provided prior to treatment and included in your Informed Consent document with Interlace Mental Health.
What is a Good Faith Estimate?
A GFE is a document that outlines the estimated cost of your mental health services for a defined period of time. This includes direct costs like session fees, as well as any other anticipated expenses. It's designed to protect you from unexpected or "surprise" medical bills.
It's important to remember that a GFE is only an estimate, not a bill or a contract. The final cost may vary depending on the actual course of your treatment, as the duration and frequency of mental health services can change based on your needs.
Who gets a Good Faith Estimate?
You have the right to receive a GFE if you fall into one of these categories:
-
You don't have health insurance.
-
You have insurance, but you're not planning to use it for your mental health services (e.g., you prefer to pay out-of-pocket).
If you plan to use your health insurance benefits, the GFE does not apply to you.
Receiving the Estimate
You have the right to receive a GFE in writing at least one business day before your scheduled service. You can also request a GFE at any time, even before you schedule an appointment.
Disputing Your Bill
A key protection of the law is the patient-provider dispute resolution process. If you receive a final bill that is $400 or more than the total amount listed on your GFE, you have the right to dispute the charge. You can save a copy of your GFE as a record to support your claim.
What the Estimate Includes
A GFE for mental health services should include:
-
A clear description of the services (e.g., psychotherapy sessions).
-
The expected costs for each service.
-
A list of the providers and facilities involved.
-
An estimate of the total expected cost.
-
The dates the estimate is valid for.
The estimate may also include details on potential recurring services, like weekly therapy sessions, to give you a clearer picture of long-term costs.
More Information
For more details on your rights and the No Surprises Act, you can visit the official website for the Centers for Medicare & Medicaid Services (CMS) at www.cms.gov/nosurprises or contact the Colorado Division of Insurance at 303-894-7490.