Your Rights

Under the No Surprises Act, individuals who are uninsured or who choose not to use insurance for their care have the right to receive a Good Faith Estimate of the expected cost of scheduled healthcare services.

• 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

• If you are uninsured or choosing not to use insurance, you have the right to receive a written Good Faith Estimate of the expected charges for scheduled services.

  Good Faith Estimates are provided within the timeframes required by federal law based on when your care is scheduled. At Heal Thyself Institute, estimates are typically provided as part of the new patient paperwork when applicable.

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

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 301
Naples, FL 34119

(239) 955-1355

support@healthyselfswfl.com