Good Faith Estimate Notice

Arkehra Therapy

Under the No Surprises Act, healthcare providers are required to provide clients who are not using insurance with a Good Faith Estimate of expected charges for services.

You have the right to receive a Good Faith Estimate explaining the anticipated cost of mental health services.

A Good Faith Estimate includes:

• The expected cost of therapy services
• The frequency and duration of sessions when known
• Any additional anticipated services related to care

This estimate is intended to help you understand and plan for the financial aspects of treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through a federal dispute resolution process.

You may request a Good Faith Estimate before scheduling services or at any time during treatment.

For questions or to request a Good Faith Estimate, please contact:

Arkehra Therapy
mayra@arkehra.com

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the U.S. Department of Health and Human Services (HHS) at (800) 368-1019.