Good Faith Estimate of Costs

Beginning on January 1, 2022, prior to receiving services, healthcare providers must provide a "good faith estimate" of expected charges to individuals who are uninsured or who do not plan to submit claims to their insurance. This policy helps individuals understand the costs of service in advance.

As ATSA is an out-of-network provider, we provide a list of fees upfront in the ATSA Patient-Services Agreement when the intake is being scheduled. Administrators will also inform you of costs in the confirmation emails at the time of booking. As a patient, or responsible party of a patient, you can request a "good faith estimate" of services at any time. 

It is recommended that you keep a copy of any "good faith estimates" you receive in a safe place or take pictures of them, so you can reference them at a later date if you suspect your are being overcharged. If there is a $400.00 or more discrepancy between your copy of the "good faith estimate" and the billed amount, you have the right to dispute.

Note that the "Good Faith Estimate" is based on the provider's knowledge at the time that the estimate was given. As the patient progresses in treatment, it is likely that the treatment plan will change, which may in turn change the original "good faith estimate". The Good Faith Estimate does not include any unexpected costs
that may arise during the course of the treatment plan.

Read More About Your Rights Under the Good Faith Estimate

Go to: www.cms.gov/nosurprises/consumers

Call 1-800-985-3059