Jennifer Jaber LMFT

The “Good Faith Estimate” is a law that requires healthcare providers, including therapists, to provided to private pay clients with an estimated cost of the services received. While it is not possible for a psychotherapist to know, in advance, how many therapy sessions may be necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. 

You have the right to initiate a dispute resolution process if the actual amount charged to you substantially exceeds (by $400 or more) the estimated charges stated in your Good Faith Estimate.

You are encouraged to speak with your provider at any time about any questions you may have regarding your treatment plan, or the information provided to you in this Good Faith Estimate.

For more information, visit https://www.cms.gov/nosurprises/consumers or call 1- 800-985-3059.