Your Right to a Good Faith Estimate
New Dawn Counseling & Therapy — No Surprises Act Notice
Notice of Your Right to a Good Faith Estimate of Expected Charges
Under the federal No Surprises Act, you have the right to receive a Good Faith Estimate explaining how much your care at New Dawn Counseling & Therapy is expected to cost.
Providers are required to give uninsured clients an estimate of expected charges for services.
What this means for you:
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency health care services, including psychotherapy sessions.
You can ask New Dawn Counseling & Therapy for a Good Faith Estimate before you schedule a service, or at any time during treatment.
If you schedule a service, you will receive a Good Faith Estimate in writing at least one business day before your appointment.
For ongoing therapy, your Good Faith Estimate may cover expected recurring sessions for up to 12 months, and will be updated at least annually or when your treatment plan or fees change.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through a federal patient-provider dispute resolution process.
Make sure to save a copy or picture of your Good Faith Estimate.
At New Dawn Counseling & Therapy, session fees are published openly on the FAQ page, and every private-pay client receives a written Good Faith Estimate before beginning care, so you will always know your expected costs upfront.
Questions or requests:
To request a Good Faith Estimate, contact:
Ruth Alcantara-Zboinski, LCSW-QS Phone: 800-914-7438 Email: ruth@newdawncounselingandtherapy.com
For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
This notice is provided in accordance with the No Surprises Act (Consolidated Appropriations Act, 2021) and 45 CFR §149.610.