Your right to a Good Faith Estimate

Why this applies to nearly everyone here

This practice is still contracting with Indiana health plans. Until those contracts are in place, appointments are self-pay, which means the protections on this page apply to almost every patient.

What the law provides

Under the No Surprises Act, healthcare providers must give patients who are uninsured or who are not using insurance an estimate of the expected charges for medical services, including psychiatric care.

• You have the right to receive a Good Faith Estimate explaining how much your care is expected to cost.
• Statutory delivery timeline: You are entitled to receive your written estimate at least 1 business day before your appointment if you schedule at least 3 business days in advance; at least 3 business days before your appointment if you schedule at least 10 business days in advance; and within 3 business days of your request if you ask before scheduling.
• If you receive a bill that is at least 400 dollars more than your Good Faith Estimate, you may dispute the bill within 120 calendar days.
• Keep a copy of your estimate.

What an estimate here will cover

The estimate lists the expected services and the charge for each: the initial evaluation, and follow-up appointments at the frequency currently anticipated. Psychiatric care is collaborative and tailored to your progress, so the estimate reflects what is reasonably expected at the time it is written and is not a cap on what care may be needed. There may be additional items or services recommended during the course of your care that are not reflected in your initial estimate.

The estimate covers services provided directly by this practice. It does not cover charges from outside laboratories, pharmacies, or other independent healthcare providers you may be referred to. Each of those facilities issues its own separate estimate.

How to ask for one

Ask when you book, or email contact@stillmindmentalhealth.com at any point before scheduling. An estimate is provided whether or not you go on to book.

Disputing a bill

If the billed amount exceeds your Good Faith Estimate by 400 dollars or more, you may start a patient-provider dispute resolution process with the United States Department of Health and Human Services within 120 calendar days of the date on the original bill. Starting a dispute requires paying a small administrative fee (currently 25 dollars) and will not affect the quality or availability of care you receive. If the dispute resolution entity agrees with your claim, the fee is deducted from your final bill.

A Good Faith Estimate is for your information only. It is not a contract and does not obligate you to receive any services from this practice.

For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.

Effective September 2026.