Heidi Stevenson, PhD, MSW
Good Faith Estimate
Effective Date: August 9, 2026
Your Right to a Good Faith Estimate
If you do not have health insurance, or you have insurance but choose not to use it to pay for therapy, you have the right to receive a written Good Faith Estimate of the expected cost of your care.
A Good Faith Estimate can help you understand what you may be charged before receiving services. It is an estimate, not a bill or a contract, and you are not required to receive services from me simply because you requested or received an estimate. Federal law applies these protections both to people without health insurance and to people who have insurance but choose not to submit a claim for the services they are receiving.
When You Will Receive an Estimate
If you are uninsured or paying for therapy yourself without using insurance, you may ask for a Good Faith Estimate at any time, including before you decide whether to begin therapy.
If you schedule services:
- 3 to 9 business days in advance: I will provide your Good Faith Estimate no later than 1 business day after scheduling.
- 10 or more business days in advance: I will provide your Good Faith Estimate no later than 3 business days after scheduling.
- If you request an estimate before scheduling: I will provide it within 3 business days of your request.
Federal law does not require a Good Faith Estimate when a service is scheduled fewer than 3 business days in advance.
What Your Good Faith Estimate Will Include
Your individualized Good Faith Estimate will include the therapy services that I reasonably expect to provide and the expected charges for those services based on the information available at the time the estimate is prepared.
For ongoing therapy, a Good Faith Estimate may cover recurring sessions for a period of up to 12 months. The estimate will describe the anticipated frequency and scope of services. If therapy continues beyond the period covered by the estimate, or if the expected scope or cost of your care changes, I will provide an updated estimate when required
Your actual treatment needs may change over time. The number or frequency of sessions you choose to attend may also change. Because of this, the total amount you ultimately pay may be different from the amount originally estimated
A Good Faith Estimate is based on the services reasonably expected at the time it is created and may not include services that could not reasonably have been anticipated.
If Your Bill Is Higher Than Your Estimate
Keep a copy of your Good Faith Estimate so you can compare it with the bills you receive.
If the amount billed by a provider is $400 or more above the amount listed for that provider on your Good Faith Estimate, you may be eligible to use the federal Patient-Provider Dispute Resolution process.
You generally must begin the dispute process within 120 calendar days of receiving the initial bill. An independent third party reviews the estimate and the billed charges as part of that process. Using the dispute-resolution process will not adversely affect the quality of healthcare services you receive.
For information about Good Faith Estimates, your rights under the No Surprises Act, or the Patient-Provider Dispute Resolution process, you can contact the No Surprises Help Desk at 1-800-985-3059 or visit the Centers for Medicare & Medicaid Services No Surprises resources.
Michigan Protections
Michigan law also provides protections related to certain nonemergency services provided by healthcare providers who do not participate with a patient's health plan.
When Michigan's surprise-billing requirements apply, a nonparticipating provider must provide the disclosures and good-faith cost estimate required under Michigan law before providing the applicable services. I will provide any additional disclosures or cost information required by Michigan law when those requirements apply to your care.
Request a Good Faith Estimate
If you are uninsured, plan to pay for therapy yourself without using your health insurance, or simply have questions about what therapy may cost, you can contact me to request a Good Faith Estimate.
Heidi Stevenson, PhD, MSW