Your Right to a Good Faith Estimate

Under the No Surprises Act (Public Law 116-260), healthcare providers are required to give patients who do not have insurance or who choose not to use insurance an estimate of the bill for medical items and services.

At MindFuel Mental Health, we are committed to billing transparency so you can make informed decisions about your mental health care.

What is a Good Faith Estimate?

A Good Faith Estimate (GFE) shows the costs of items and services that are reasonably expected for your health care needs. The estimate is based on information known at the time the estimate was created and does not include any unknown or unexpected costs that may arise during treatment.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychiatric evaluations, medication management sessions, testing, and therapy.

  • If you schedule care at least 3 business days in advance, MindFuel Mental Health will provide you with a Good Faith Estimate in writing within 1 business day after scheduling.

  • If you schedule care at least 10 business days in advance, we will provide your written estimate within 3 business days after scheduling.

  • You can also request a Good Faith Estimate in writing at any time before you schedule an appointment.

What You Should Know

  • The Estimate is Not a Contract: A Good Faith Estimate is for your informational purposes only. It does not obligate you to receive any services from MindFuel Mental Health.

  • Save Your Copy: Be sure to save a copy or picture of your Good Faith Estimate.

  • If Your Bill is Higher Than Expected: If you receive a bill from MindFuel Mental Health that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through the federal Patient-Provider Dispute Resolution Process.

Questions or Disputes?

If you have questions about your bill or wish to request a Good Faith Estimate prior to scheduling, please contact our billing department:

  • Billing Phone: 1-888-454-1440

  • Billing Email: mindfuel@onesourcercm.com

  • Practice Phone: 727-223-1579

For more information about your rights under federal law or to initiate a dispute, visit the U.S. Centers for Medicare & Medicaid Services (CMS) website at www.cms.gov/nosurprises or call 1-800-985-3059.