Good Faith Estimate Notice

Under the law, you have the right to receive a “Good Faith Estimate” (GFE) explaining how much your counseling services may cost.

Your Rights:

• You have the right to receive a Good Faith Estimate for the total expected cost of services when you are uninsured or choosing not to use insurance.

• You can request a Good Faith Estimate before scheduling a service or at any time during your care.

• The Good Faith Estimate will include the expected costs for services we reasonably anticipate providing.

Important Details:

• This is only an estimate; actual charges may vary depending on your needs and the course 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.

• You should save a copy of your Good Faith Estimate for your records.

For More Information:

• To learn more about your rights under federal law, visit: www.cms.gov/nosurprises

• Or call the No Surprises Help Desk at 1-800-985-3059.

Mental Health Bill of Rights

You can view the full text — as required by N.H. Code Admin. R. Mhp 502.02 — on the New Hampshire Department of Health and Human Services website via their document titled "He-M 309: Rights of Persons Receiving Mental Health Services in the Community." NH DHHS