Good Faith Estimate (GFE) & The No Surprises Act

What Is a Good Faith Estimate?

A Good Faith Estimate (GFE) is a document that provides:

• A clear explanation of the expected cost of your evaluation or service

• An itemized list of all reasonably expected charges

• A projected time frame for completing the service

• Clarification that the actual cost may differ if additional time or testing is needed

• Information on your right to dispute a bill that is $400 or more above the estimate

The GFE is not a bill. It is designed to increase transparency and prevent unexpected charges.

Who Receives a Good Faith Estimate?

You are eligible for a GFE if:

• You are paying out of pocket

• You are not submitting for insurance reimbursement

• You are uninsured

• You request a GFE at any time

In my practice, all clients receive a Good Faith Estimate before scheduling an autism assessment or consultation package.

What Will Your Estimate Include?

Your GFE will include expected charges for any services you choose, such as:

• Comprehensive adult autism assessments

• Pediatric autism assessments

• Diagnostic interviewing and record review

• Standardized testing (SRS-2, MIGDAS-2, SP-2, etc.)

• Scoring, interpretation, and clinical formulation

• Written diagnostic report preparation

• Feedback session

• Parent consultation sessions

• Support groups 

• Training classes or workshops

Because autism evaluations vary in complexity, your GFE will reflect the total hours and components required for your individual case.

Your Rights

Under federal law, you have the right to:

• Receive a Good Faith Estimate in writing at least 1 business day before your scheduled service

• Request an updated estimate if your service needs change

• Dispute a bill if it is $400+ higher than your GFE

• Receive care without discrimination or penalty for requesting an estimate

Dispute Process

If you receive a bill that is substantially higher than the Good Faith Estimate, you may:

1. Contact me first to discuss the discrepancy.

2. File a formal dispute with the U.S. Department of Health & Human Services (HHS).

3. Submit the dispute within 120 days of receiving the bill.

You can learn more about this process at:
www.cms.gov/nosurprises