Good Faith Estimate: Your Right to Know Costs in Advance
Under federal law, you have the right to receive a Good Faith Estimate that explains how much your medical care will cost if you are not using insurance or do not have insurance.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes costs related to therapy or psychiatric services, as well as associated fees (e.g., labs, prescriptions, or administrative costs if applicable).
You should receive your Good Faith Estimate in writing at least one (1) business day before your scheduled service.
You may also request a Good Faith Estimate from Sonder Psychiatric Services at any time before scheduling.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
Please keep a copy or take a photo of your Good Faith Estimate for your records.
For more information or questions about your right to a Good Faith Estimate:
Visit: www.cms.gov/nosurprises
Call the No Surprises Help Desk: 1-800-985-3059
Contact Sonder Psychiatric Services: 608-949-2045 or admin@sonderpsychiatricservices.com
Your Protections Against Surprise Medical Bills
When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing (also known as surprise billing).
What is Balance Billing?
Balance billing happens when you are charged the difference between what your health insurance pays and what an out-of-network provider charges. This can result in unexpected high costs.
When You’re Protected:
You are protected from balance billing when:
You receive emergency services from an out-of-network provider or facility.
You receive certain services at an in-network hospital or ambulatory surgical center from an out-of-network provider (e.g., anesthesiology, radiology, pathology).
In these situations:
You cannot be charged more than your in-network cost-sharing amount (copayments, coinsurance, deductibles).
You do not need to give up your protections or sign a consent to receive out-of-network care.
Your Additional Protections:
Your health plan must cover emergency services without prior authorization, even if they are out-of-network.
Your plan must pay out-of-network providers directly and apply your cost-sharing based on in-network rates.
Any amounts you pay toward these services must count toward your deductible and out-of-pocket limits.
If you believe you were incorrectly billed:
Contact the No Surprises Help Desk at 1-800-985-3059
Contact Sonder Psychiatric Services at 608-949-2045 or
admin @sonderpsychiatricservices.com
For full details about your rights under the No Surprises Act, visit: www.cms.gov/nosurprises
Sonder Psychiatric Services is committed to transparency, compassionate care, and ethical billing practices for all clients.