Alexandra
Burg LISW BCD ACSW LLC
1554
Novicky Court
South
Euclid, OH 44121
(216) 584-9224 alex.burg.lisw.s@gmail com
January
01/01/2024
NPI: 1366605958 EIN: 83-1568812
Good
Faith Estimate Notice
You
have the right to receive a “Good Faith Estimate” explaining how
much your medical and mental health care will cost.
Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.
You can ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
If you receive a bill that is at least $400. more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.