Good Faith Estimate

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.
You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

Frequently Asked Questions

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HIPAA Compliance

HOW TO COMPLAIN ABOUT MY PRIVACY PRACTICES

If you think I may have violated your privacy rights, you may file a complaint with Karine Echighian, as the Privacy Officer for my practice, and my address and phone number are: 5900 Canoga Ave, Ste. 350 Woodland Hills, CA 91367. (818) 453-2258.

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:

  1. Sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201;
  2. Calling 1-877-696-6775; or,
  3. Visiting www.hhs.gov/ocr/privacy/hipaa/complaints

I will not retaliate against you if you file a complaint about my privacy practices.

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