Good Faith Estimate

The federal No Surprises Act (the “Act”), requires all healthcare providers, including psychiatrists and therapists, to notify uninsured and self-pay patients of their right to receive a good faith estimate (“GFE”) of expected charges upon request or upon scheduling an item or service.

Noor Psychiatry and Wellness (“Noor P&W”) currently requires all patients to self-pay for services before treatment begins. This document serves as notice that Noor P&W is required to provide you with a GFE of the expected cost of the items and/or services Noor P&W reasonably expects you to receive for treatment upon request or scheduling.

If you receive a bill that is at least $400 more than the GFE provided to you by Noor P&W, you have the right to dispute your bill.

Providing a GFE is particularly challenging in mental health care because it is difficult to predict the duration and frequency of treatment and because patients have a right to decide how long they want to receive treatment. Therefore, please be aware that the GFE provided by Noor P&W is based only on the information known by Noor P&W as of the date set forth in the GFE. Noor P&W will provide you with an updated GFE in the event of any changes in the information or scope of the GFE. 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.