Good Faith Estimate Notice

Alexandra Burg LISW BCD ACSW LLC
1554 Novicky Court
South Euclid, OH 44121
(216) 703-5523 [email protected] com

January 01/01/2022

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.

Testimonials

Alexandra Burg LISW BCD ACSW LLC

Availability

Primary

Monday:

Closed

Tuesday:

12:00 pm-7:00 pm

Wednesday:

12:00 pm-7:00 pm

Thursday:

12:00 pm-7:00 pm

Friday:

Closed

Saturday:

12:00 PM-5:00 PM

Sunday:

Closed