Good Faith Estimate — Subpage Development LedgerFieldWorking DecisionPageGood Faith Estimate
Top-menu labelNo top-menu tab
Parent / hub pagePolicies & Notices
URL / permalink/good-faith-estimate
Search visibilityUsually index
Footer linkYes
Page roleFull Good Faith Estimate notice page
SEO roleCompliance/trust support, not marketing
E-E-A-T roleTrustworthiness: explains federal cost-estimate rights for self-pay or uninsured clients
Governance statusLegal/compliance page; preserve source wording unless specifically revising
Primary source controlExisting Good Faith Estimate Notice document
Main purposeInform self-pay or uninsured clients of their right to receive a Good Faith Estimate explaining expected mental health service costs
IncludeTitle; self-pay/uninsured applicability; what the GFE includes; estimate limits; when the GFE is provided; updated-estimate trigger; dispute rights; how to request a GFE; provider contact information
ExcludeMarketing copy; exact fees unless separately approved; insurance-promotion language; guarantees that actual charges will not change; broad legal advice
Internal links from pagePolicies & Notices; Fees & Payment; Contact
Cross-links to pagePolicies & Notices; Footer; Fees & Payment where relevant
ToneFormal, plain, compliance-oriented
QA statusSource exists; page not yet drafted into Weebly formatRequired content blocksOrderSectionFunction1Good Faith Estimate NoticePage title
2For Self-Pay or Uninsured ClientsApplicability
3Right to Receive a Good Faith EstimateCore legal right
4What the Good Faith Estimate IncludesScope of estimate
5Estimate LimitsNot a bill, not a contract, may change
6When You Will Receive a Good Faith EstimateTiming rules
7Updated EstimateMaterial change trigger
8Your Dispute Resolution RightsPPDR rights if bill is $400 or more above GFE
9How to Request a Good Faith EstimateContact/provider block
10Legal basis statementNo Surprises Act / 45 CFR §149 applicabilitySource facts already availableSource FactCitationThe notice is titled GOOD FAITH ESTIMATE NOTICE and applies to self-pay or uninsured clients.
The notice states that health care providers must provide a Good Faith Estimate to individuals who do not have insurance or who choose not to use insurance.
The GFE includes expected charges, covers a defined period of care, and is based on information known at the time it is issued.
The GFE is not a bill and not a contract, and actual charges may change if treatment needs or circumstances change.
The notice includes dispute rights if a bill is $400 or more above the GFE and states the dispute must be initiated within 120 days of receiving the bill.Controlled namingUseAvoidGood Faith Estimate NoticeBilling Rights
Good Faith EstimateCost promise
Self-pay or uninsured clientscash clients only
Not a bill and not a contractguaranteed final cost
Patient-Provider Dispute Resolution / PPDRinformal billing appeal
Expected chargesfixed price guaranteePage decisionThis page should be a standalone legal-notice page, linked from Policies & Notices, Fees & Payment where relevant, and the footer. It should not be placed in the top navigation.
Freeze and no drift.
Top-menu labelNo top-menu tab
Parent / hub pagePolicies & Notices
URL / permalink/good-faith-estimate
Search visibilityUsually index
Footer linkYes
Page roleFull Good Faith Estimate notice page
SEO roleCompliance/trust support, not marketing
E-E-A-T roleTrustworthiness: explains federal cost-estimate rights for self-pay or uninsured clients
Governance statusLegal/compliance page; preserve source wording unless specifically revising
Primary source controlExisting Good Faith Estimate Notice document
Main purposeInform self-pay or uninsured clients of their right to receive a Good Faith Estimate explaining expected mental health service costs
IncludeTitle; self-pay/uninsured applicability; what the GFE includes; estimate limits; when the GFE is provided; updated-estimate trigger; dispute rights; how to request a GFE; provider contact information
ExcludeMarketing copy; exact fees unless separately approved; insurance-promotion language; guarantees that actual charges will not change; broad legal advice
Internal links from pagePolicies & Notices; Fees & Payment; Contact
Cross-links to pagePolicies & Notices; Footer; Fees & Payment where relevant
ToneFormal, plain, compliance-oriented
QA statusSource exists; page not yet drafted into Weebly formatRequired content blocksOrderSectionFunction1Good Faith Estimate NoticePage title
2For Self-Pay or Uninsured ClientsApplicability
3Right to Receive a Good Faith EstimateCore legal right
4What the Good Faith Estimate IncludesScope of estimate
5Estimate LimitsNot a bill, not a contract, may change
6When You Will Receive a Good Faith EstimateTiming rules
7Updated EstimateMaterial change trigger
8Your Dispute Resolution RightsPPDR rights if bill is $400 or more above GFE
9How to Request a Good Faith EstimateContact/provider block
10Legal basis statementNo Surprises Act / 45 CFR §149 applicabilitySource facts already availableSource FactCitationThe notice is titled GOOD FAITH ESTIMATE NOTICE and applies to self-pay or uninsured clients.
The notice states that health care providers must provide a Good Faith Estimate to individuals who do not have insurance or who choose not to use insurance.
The GFE includes expected charges, covers a defined period of care, and is based on information known at the time it is issued.
The GFE is not a bill and not a contract, and actual charges may change if treatment needs or circumstances change.
The notice includes dispute rights if a bill is $400 or more above the GFE and states the dispute must be initiated within 120 days of receiving the bill.Controlled namingUseAvoidGood Faith Estimate NoticeBilling Rights
Good Faith EstimateCost promise
Self-pay or uninsured clientscash clients only
Not a bill and not a contractguaranteed final cost
Patient-Provider Dispute Resolution / PPDRinformal billing appeal
Expected chargesfixed price guaranteePage decisionThis page should be a standalone legal-notice page, linked from Policies & Notices, Fees & Payment where relevant, and the footer. It should not be placed in the top navigation.
Freeze and no drift.
GOOD FAITH ESTIMATE PAGE — Improved Writing, E-E-A-T / SEO PreservedPage nameGood Faith Estimate Notice
Recommended permalink/good-faith-estimate-notice
SEO titleGood Faith Estimate Notice | Rebecca S. de Vries, Ph.D., LPC
Meta descriptionGood Faith Estimate information for self-pay or uninsured clients receiving online psychotherapy services from Rebecca S. de Vries, Ph.D., LPC.
Good Faith Estimate NoticeFor self-pay or uninsured clients
You have the right to receive a Good Faith Estimate explaining the expected cost of mental health services.
Under federal law, health care providers must provide a Good Faith Estimate to individuals who do not have insurance or who choose not to use insurance.
What the Good Faith Estimate IncludesA Good Faith Estimate includes expected charges for psychotherapy and other reasonably anticipated mental health services.
The estimate:
When You Will Receive a Good Faith EstimateIf services are scheduled at least 10 business days in advance, you will receive a Good Faith Estimate within 3 business days of scheduling.
If services are scheduled at least 3 business days in advance, you will receive a Good Faith Estimate within 1 business day of scheduling.
If services are not yet scheduled, you may request a Good Faith Estimate at any time.
Updated EstimatesA new or updated Good Faith Estimate will be provided if there is a material change in expected services or costs.
Your Dispute Resolution RightsIf you receive a bill that is $400 or more above the amount listed in your Good Faith Estimate, you may have the right to dispute the charges through the federal Patient-Provider Dispute Resolution process.
Important details:
https://www.cms.gov/nosurprises
How to Request a Good Faith EstimateRebecca S. de Vries, Ph.D., LLC
Rebecca S. de Vries, Ph.D., LPC
Phone: (724) 816-7771
Website: www.rebeccadevries.com
ApplicabilityThis notice is provided in accordance with the No Surprises Act and applies only to uninsured and self-pay clients.
Footer-level disclaimer for Good Faith Estimate pageThis page provides general Good Faith Estimate information for self-pay or uninsured clients. It is not a bill, not a contract, and does not replace an individualized Good Faith Estimate when required.
Freeze and no drift.
Recommended permalink/good-faith-estimate-notice
SEO titleGood Faith Estimate Notice | Rebecca S. de Vries, Ph.D., LPC
Meta descriptionGood Faith Estimate information for self-pay or uninsured clients receiving online psychotherapy services from Rebecca S. de Vries, Ph.D., LPC.
Good Faith Estimate NoticeFor self-pay or uninsured clients
You have the right to receive a Good Faith Estimate explaining the expected cost of mental health services.
Under federal law, health care providers must provide a Good Faith Estimate to individuals who do not have insurance or who choose not to use insurance.
What the Good Faith Estimate IncludesA Good Faith Estimate includes expected charges for psychotherapy and other reasonably anticipated mental health services.
The estimate:
- Covers a defined period of care
- Is based on information known at the time it is issued
- Is not a bill
- Is not a contract
- Does not require you to receive services
When You Will Receive a Good Faith EstimateIf services are scheduled at least 10 business days in advance, you will receive a Good Faith Estimate within 3 business days of scheduling.
If services are scheduled at least 3 business days in advance, you will receive a Good Faith Estimate within 1 business day of scheduling.
If services are not yet scheduled, you may request a Good Faith Estimate at any time.
Updated EstimatesA new or updated Good Faith Estimate will be provided if there is a material change in expected services or costs.
Your Dispute Resolution RightsIf you receive a bill that is $400 or more above the amount listed in your Good Faith Estimate, you may have the right to dispute the charges through the federal Patient-Provider Dispute Resolution process.
Important details:
- The dispute must be initiated within 120 days of receiving the bill.
- The process is administered by the U.S. Department of Health and Human Services.
- Instructions for initiating a dispute will be provided with your bill or Good Faith Estimate.
https://www.cms.gov/nosurprises
How to Request a Good Faith EstimateRebecca S. de Vries, Ph.D., LLC
Rebecca S. de Vries, Ph.D., LPC
Phone: (724) 816-7771
Website: www.rebeccadevries.com
ApplicabilityThis notice is provided in accordance with the No Surprises Act and applies only to uninsured and self-pay clients.
Footer-level disclaimer for Good Faith Estimate pageThis page provides general Good Faith Estimate information for self-pay or uninsured clients. It is not a bill, not a contract, and does not replace an individualized Good Faith Estimate when required.
Freeze and no drift.