Notice of Good Faith Act
Wisconsin Therapy Center, LLC
6410 Enterprise Lane - Suite 130
Madison, Wisconsin 53719
608-819-8800
Effective Date: January 01, 2022
This Notice Complies with The No Surprises Act (H.R. 133)
NOTICE TO CLIENTS AND PROSPECTIVE CLIENTS
Under the law health care providers need to give clients, who don’t have insurance or who are not using insurance, an estimate of the expected charges for medical services including psychotherapy services..
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services including psychotherapy services.
You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service or at any time during treatment.
If you receive a bill that is at least $400 more than your Good Faith Estimate you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, see your Estimate, or visit www.cms.gov/nosurprises or call 800-985-3059.