Good Faith Estimate
Under the law, you have the right to receive a "Good Faith Estimate" explaining how much your medical and mental health care will cost.
What is a Good Faith Estimate?
It's an estimate of the expected charges for scheduled or requested non-emergency health care items and services. This helps you understand and plan for your healthcare costs in advance.
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Who receives a Good Faith Estimate?
This estimate is available to you if you are:
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Uninsured: You do not have health insurance coverage.
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Self-Pay: You have health insurance, but you choose not to use your benefits for the services provided by Dr. Kristan Melo, Licensed Psychologist (e.g., for privacy reasons, or because you prefer to pay out-of-pocket).
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When will you receive an estimate?
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Upon Request: You can ask Dr. Kristan Melo for a Good Faith Estimate before you schedule a service. If you do, we will provide it to you within 3 business days of your request.
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Upon Scheduling:
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If you schedule a service at least 3 business days in advance, we will provide you with a Good Faith Estimate in writing within 1 business day of scheduling.
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If you schedule a service at least 10 business days in advance, we will provide you with a Good Faith Estimate in writing within 3 business days of scheduling.
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Important Considerations:
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The Good Faith Estimate shows the expected costs for the services that are reasonably anticipated for your mental health care needs.
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It does not include any unknown or unexpected costs that may arise during treatment, such as complications or additional services you may choose to receive.
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If you receive a bill that is at least $400 or more than your Good Faith Estimate, you have the right to dispute the bill.
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For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.