Good Faith Estimate & No Surprises Act

Effective Date: 08/03/2026

Understanding Your Rights

At Beacon Psychological Services, LLC, we believe financial transparency is an important part of quality care. Before services begin, we want you to understand both the expected cost of care and your rights under federal law.

The No Surprises Act gives individuals who are uninsured or who choose not to use their insurance benefits the right to receive a Good Faith Estimate of expected healthcare costs before receiving services.

What is a Good Faith Estimate?

A Good Faith Estimate is a written estimate of the expected costs associated with your care.

The estimate reflects the information available at the time it is prepared and is designed to help you make informed decisions before services begin.

Depending on your needs, your estimate may include:

  • Initial consultation

  • Psychological evaluation

  • Therapy sessions

  • Report preparation

  • Feedback appointments

  • Other anticipated professional services

Because every person’s needs are unique, an estimate is not a guarantee of the frequency, length, or total cost of services. Actual costs may differ if additional services become clinically appropriate, or if unexpected circumstances arise during the course of care.

Receiving a Good Faith Estimate does not obligate you to receive services from Beacon Psychological Services, LLC.

Who Can Receive One?

You have the right to request a Good Faith Estimate if you:

  • Do not have health insurance.

  • Choose not to use your insurance benefits.

  • Are receiving services on a self-pay basis.

Beacon Psychological Services, LLC is happy to provide a written Good Faith Estimate before services begin or upon request.

What If My Final Bill Is Higher?

If you receive a bill that is at least $400 more than your Good Faith Estimate, federal law allows you to begin a patient-provider dispute resolution process.

If this occurs, you may:

  • Contact Beacon Psychological Services, LLC to discuss the charges.

  • Ask us to update the bill to match your Good Faith Estimate.

  • Ask questions about the services provided.

  • Ask whether financial assistance is available.

  • Initiate the federal dispute resolution process if necessary.

If you choose to use the federal dispute resolution process, you must begin within 120 calendar days of the date on your original bill. There is a $25 fee to use the process. If the reviewing agency agrees with you, you will pay the amount listed on your Good Faith Estimate. If the reviewing agency agrees with the provider, you will pay the higher billed amount.

Please Keep Your Estimate

We recommend saving a copy of your Good Faith Estimate for your records, or taking a photograph of it. If questions arise later regarding billing, your estimate will serve as an important reference.

Questions About Costs?

We encourage you to ask questions at any point during the process. Before services begin, we’ll discuss anticipated fees, payment options, and answer any financial questions you may have.

Our goal is for you to feel informed and confident, not surprised.

Additional Resources

For more information about your rights under the No Surprises Act, visit:

Centers for Medicare & Medicaid Services (CMS) https://www.cms.gov/nosurprises or call 1-800-985-3059.