No Surprises Act Notice

Your Rights and Protections Against Surprise Medical Bills

What Is the No Surprises Act?

The No Surprises Act is a federal law designed to protect clients like you from surprise bills. It ensures you have access to clear information about the costs of your care before receiving services.

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Your Rights Under the No Surprises Act:

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Good Faith Estimate:

• If you are not using insurance or are self-paying for services, you have the right to receive a Good Faith Estimate of the expected costs of therapy or counseling services.

• This estimate will outline the anticipated charges for services provided by Courtney Brain, LMFT & Associates.

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What Is a Good Faith Estimate?

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• A Good Faith Estimate is a document that provides an upfront summary of the expected costs for your care.

• You can request a Good Faith Estimate before scheduling your first session or at any time during treatment.

How to Request a Good Faith Estimate

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You can request a Good Faith Estimate by:

• Calling us at (916) 250-3108

• Emailing courtney@courtneybrainlmft.com

• Speaking with your counselor directly

We will provide your estimate within three business days of your request.

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Important Notes:

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• The Good Faith Estimate is not a bill. Actual charges for services may vary depending on your treatment needs.

• If you receive a bill that is $400 or more than your Good Faith Estimate, you have the right to dispute the charge.

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How to Learn More

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For more information about your rights under the No Surprises Act, you can visit the official government website at www.cms.gov/nosurprises.

At Courtney Brain, LMFT & Associates, we strive to provide quality care while ensuring you feel informed and empowered throughout your therapeutic journey. If you have questions about our fees or your rights under the No Surprises Act, please don’t hesitate to reach out.