Your Rights

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
This includes related costs such as:

• Consultations and evaluations

• Therapies or treatments

• Lab testing or diagnostic procedures

• Supplements, if applicable

• Any other items or services you request as part of your care plan

If you are uninsured or not using insurance for your visit, your provider will give you a written Good Faith Estimate before your service.
You can also request an estimate in advance for any service at any time.

When You Will Receive Your Estimate

• You will receive your written Good Faith Estimate at least one business day before your scheduled appointment.

• Estimates are sent as part of your new patient paperwork when you book your first appointment.

• Make sure to keep a copy of your estimate for your records.

Disputing a Bill

If you receive a bill that is $400 or more than your Good Faith Estimate, you have the right to dispute the bill.
You can start a dispute process with the U.S. Department of Health and Human Services (HHS).

For more information about your rights and the dispute process, visit:
👉 www.cms.gov/nosurprises

Our Commitment

At Heal Thyself Institute, we strive to ensure all patients understand the expected costs of their care.
Our team is available to answer questions and provide estimates for any service before you schedule.

For additional questions or to request a new copy of your Good Faith Estimate, please contact:

Heal Thyself Institute
2590 Northbrooke Plaza Dr, Suite 107
Naples, FL 34119

(239) 955-1355

support@healthyselfswfl.com