Good Faith Estimate
Information for uninsured and self-pay families.
If you do not have health insurance or choose not to use insurance to pay for care, federal law generally gives you the right to receive a Good Faith Estimate of expected charges before services are provided.
Your right to an estimate
You may request a Good Faith Estimate before scheduling care. You generally should also receive one when you schedule an item or service at least 3 business days in advance and you are uninsured or do not plan to use insurance to pay for the care.
When you can expect it
If care is scheduled 3–9 business days in advance, the estimate is generally provided within 1 business day after scheduling. If care is scheduled 10 or more business days in advance, it is generally provided within 3 business days. If you request an estimate before scheduling, it is generally provided within 3 business days of the request.
What the estimate includes
The Good Faith Estimate describes items or services reasonably expected to be provided by envision Behavioral Health during the applicable period of care and the expected charges for those items or services. Actual services may change based on clinical needs and circumstances.
If the bill is substantially higher
If you receive a bill that is at least $400 more than the expected charges listed on your Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process.
Requesting an estimate
To request a Good Faith Estimate from envision Behavioral Health, call (425) 940-8700 or email info@envisionABA.com. Please do not email diagnoses, medical records, or other sensitive clinical information.
Learn more about your rights
For federal information about Good Faith Estimates and the No Surprises Act, visit the Centers for Medicare & Medicaid Services or call the No Surprises Help Desk at 1-800-985-3059.
Questions?
Contact envision Behavioral Health and our team can explain the next steps for private-pay services and estimates.