Your Right to a Good Faith Estimate

Under the federal No Surprises Act, you have the right to receive a Good Faith Estimate explaining the expected cost of your health care services if you do not have health insurance or choose not to use your insurance to pay for services.

Joy Counseling Services, LLC is a private-pay psychotherapy practice. You are responsible for the cost of services, and you may request a Good Faith Estimate to understand your anticipated therapy expenses before beginning treatment.

What Is a Good Faith Estimate?

A Good Faith Estimate is a written estimate of the expected charges for health care services. For psychotherapy, this estimate may include the anticipated cost of individual therapy sessions over a specified period of time.

Because therapy is an individualized process, the estimated total cost may depend on factors such as the frequency of sessions, anticipated duration of treatment, and your individual treatment needs.

A Good Faith Estimate is not a contract and does not require you to receive services from me. It is an estimate of expected charges, not a guarantee of the final cost.

Your Rights Under the No Surprises Act

As a self-pay client, you have the right to:

  • Request an estimate before starting services. You may request a Good Faith Estimate before scheduling or beginning psychotherapy.

  • Receive an estimate in writing. Your estimate will be provided electronically or in paper form.

  • Understand your expected costs. The estimate will outline the expected charges for the services included.

  • Receive an updated estimate when appropriate. If anticipated services, frequency, duration, or expected charges change, an updated estimate may be provided.

Providers generally must provide a Good Faith Estimate within the following timeframes:

  • If you schedule services at least 3 business days in advance, you should receive your estimate within 1 business day after scheduling.

  • If you schedule services at least 10 business days in advance, you should receive your estimate within 3 business days after scheduling.

  • If you request an estimate before scheduling services, you should receive it within 3 business days after your request.

What If Your Bill Is Higher Than Your Estimate?

If you receive a bill from me that is at least $400 more than your Good Faith Estimate, you may be eligible to use the federal Patient-Provider Dispute Resolution process to dispute the charges.

You generally must initiate the dispute within 120 days of receiving the initial bill. During the dispute process, an independent third party reviews the estimate and the bill to determine the appropriate amount.

Keep a copy of your Good Faith Estimate and any bills you receive so you can compare the estimated and actual charges.

How to Request a Good Faith Estimate

If you are considering therapy or are already receiving services and would like a Good Faith Estimate, please contact me:

Joy Counseling Services, LLC
Phone: 636-466-1994
Email: jgillespietherapy@gmail.com

For additional information about your rights under the No Surprises Act, visit the Centers for Medicare & Medicaid Services (CMS) or call the No Surprises Help Desk at 1-800-985-3059.

Last updated: November 1, 2026

GOOD FAITH ESTIMATE