If you do not have insurance, or you choose not to use your insurance, you have the right to know what your care is expected to cost before you receive it.
This notice is for patients who are not enrolled in a health plan or federal health care program, and for patients who have insurance but choose not to submit a claim for their care. We call this paying out of pocket, or self-pay.
You have the right to receive a Good Faith Estimate of the total expected charges for the services you are scheduling. You can ask for one at any time, including before you decide whether to book. Our estimate is provided in writing.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute it through a federal process. Keep a copy or a photo of your estimate so you can show it if you need to.
A Good Faith Estimate is not a contract. It does not require you to receive care from this practice, and the final charges may differ if your needs change.
To learn more about your rights, visit cms.gov/nosurprises or call the federal help desk at 1-800-985-3059.
Call or email Lisa Jimenez PMHNP PLLC and tell us which services you are considering. Please do not include medical details in a text or email.