Good Faith Estimate - Isla Psychiatry

What a Good Faith Estimate is

Under the No Surprises Act, health care providers must give patients who are uninsured, or who are not using insurance, a written estimate of the expected charges for their care. Isla Psychiatry is a self-pay practice, so this applies to everyone we see.

What you can expect from us

We will tell you about your right to a Good Faith Estimate before you schedule, and in writing.
You can ask for one at any time, for any service, before you schedule it. We will provide it within three business days of your request.
When you schedule a visit at least ten business days out, you will receive an estimate at least three business days before the visit. When you schedule between three and nine business days out, you will receive it within one business day.
The estimate will list the expected services, the associated charges, and any items we reasonably expect to be part of your care with us.

What it does not include

The estimate covers care provided by Isla Psychiatry. It does not cover services billed separately by other providers, such as laboratory work, a therapist you see elsewhere, or medications dispensed by your pharmacy. It is an estimate of expected cost, not a bill, and your actual care may change if your clinical needs change.

If your bill is higher than your estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute it. You must start the dispute process within 120 calendar days of the date on the bill. There is a small administrative fee to initiate a dispute.

For details on the patient-provider dispute resolution process, visit cms.gov/nosurprises or call 1-800-985-3059.

Keep your estimate

Save a copy of any estimate we send you. You will need it if you ever want to dispute a bill.

Questions

To request an estimate or ask about fees, email help@islapsych.com. Current fees are also discussed during the screening call before your first visit.