No Surprises Act
Good Faith Estimate
If you are uninsured or paying for care yourself, you have the right to receive a Good Faith Estimate of expected charges.
- You can ask for a Good Faith Estimate before you schedule.
- You can also ask for one at any time before you receive services.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you may dispute the bill.
Learn more about your rights under the No Surprises Act at cms.gov/nosurprises, or call 1-800-985-3059.
To request a Good Faith Estimate for Rebuild Men's Group, email derek@derekevanscounseling.com.
