Good Faith Estimate

The “Good Faith Estimate” is a part of the “No Surprises Act”, which is effective as of January 1, 2022.

There is currently an immense amount of disagreement about how the Act and the Good Faith Estimate are to be used in private practice mental health, particularly at clinics or organizations that are entirely out of network, as ERA Wellness is and always has been . There are some parts of this legislation, such as the requirement to provide a diagnosis for each client prior to the start of services, that do not make sense in any setting and do not follow best practices for ethical mental health care and assessment.

The government has released some FAQs (that can be found here), acknowledging the lack of a reasonable time frame for providers to comply with these new requirements. ERA Wellness will continue to provide ethical and well informed care to its clients as additional information is released about how this Act is to work in actual practice and who it applies to. ERA Wellness will also continue to be transparent with our past, future, and prospective clients about our fee structure and payment, again as we always have been. If you have questions about our fees or payment, please see our FAQs here, or contact me directly at emily@erawellnesstherapy.com or 414-301-3411.

Our first goal is and always has been to provide exceptional and ethical mental health care to our clients, in a way that allows you to heal in the way that you want and need to.

Emily Aleksy, LCSW, PMH-C, Clinic Owner and Director

The following is language from the government about client or patient rights under this Act:

You have the right to receive a “Good Faith Estimate” explaining how much your medical 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 bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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 or call 800-985-3059.