Good Faith Estimate & Patient Rights

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, individuals who do not have health insurance or who choose not to use their health insurance to pay for services have the right to receive a Good Faith Estimate of the expected cost of their care.

Beelieve Occupational Therapy is committed to providing families with clear and transparent information regarding the anticipated cost of occupational therapy services.

What is a Good Faith Estimate?

A Good Faith Estimate provides an estimate of the expected charges for occupational therapy services before care is provided. It is not a bill.

Your estimate may include:

• Occupational therapy evaluation fees
• Treatment session fees
• Anticipated frequency and duration of services
• Other reasonably expected charges related to your occupational therapy care

The actual services recommended may change based on evaluation findings, your child's needs, progress, and the family's goals.

When Will I Receive an Estimate?

If you are uninsured or will not be using insurance to pay for services, you generally have the right to receive a Good Faith Estimate when services are scheduled at least 3 business days in advance or when you request one.

Generally:

Services scheduled 3–9 business days in advance

Your Good Faith Estimate will be provided within 1 business day after scheduling.

Services scheduled 10 or more business days in advance

Your Good Faith Estimate will be provided within 3 business days after scheduling.

If you request an estimate before scheduling

Your Good Faith Estimate will generally be provided within 3 business days of your request.

The estimate will be provided in writing, either electronically or on paper, based on your preferred method of delivery.

If Your Bill Is Higher Than Your Estimate

If you receive a bill from Beelieve Occupational Therapy that is at least $400 more than the amount listed on your Good Faith Estimate, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process.

Please keep a copy of your Good Faith Estimate for your records and compare it with any bills you receive.

Requesting a Good Faith Estimate

You may request a Good Faith Estimate before scheduling services or at any time before treatment begins.

To request an estimate or ask questions regarding the expected cost of services, please contact:

Additional Information

For additional information regarding your rights under the No Surprises Act, visit the official Centers for Medicare & Medicaid Services (CMS) information page:

Learn more about your medical billing rights

For questions about the No Surprises Act or Good Faith Estimates, the federal No Surprises Help Desk can be reached at 1-800-985-3059.