Good Faith Estimate

Your right to a Good Faith Estimate.

Under Section 2799B-6 of the Public Health Service Act (the federal No Surprises Act), health care providers must give clients who don't have insurance, or who aren't using insurance, an estimate of the bill for medical items and services.

What you have the right to

  • You have the right to receive a Good Faith Estimate explaining how much your care will cost.
  • You have the right to receive a Good Faith Estimate in writing at least one business day before your service. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule.
  • 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.

How to request your estimate

To request a Good Faith Estimate, contact Release Wellness directly:

Tanya L. Hauer, MSW, ACSW
Release Wellness
Email: tanya@releasewellnessca.com
Phone: (949) 687-3899

A personalized estimate will be provided in writing, typically as part of intake paperwork through the secure SimplePractice client portal once you schedule.

For more information

For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.