Notice of Availability of Good Faith Estimate
You have the right to receive a Good Faith Estimate that explains the expected cost of your child’s speech therapy services. Under federal law (the No Surprises Act), health care providers must give this estimate to families who do not have insurance or who choose not to use their insurance. This estimate is meant to help you understand and plan for the cost of care before services begin.
Your Good Faith Estimate will include a description of the services recommended for your child (such as an evaluation or ongoing therapy), how often services are expected to occur, and the estimated cost for each service, along with the total expected cost. Please note that this estimate is based on information available at the time it is created and is not a contract or guarantee of final charges.
As therapy progresses, your child’s needs may change. This may result in changes to the type, frequency, or duration of services. If that happens, you will receive an updated Good Faith Estimate as required by law. You will receive your initial estimate within required timeframes: within 3 business days after scheduling services at least 10 days in advance, within 1 business day if services are scheduled 3–9 days in advance, or within 3 business days if you request an estimate before scheduling.
If you are billed at least $400 more than your Good Faith Estimate, you have the right to dispute the charges through a federal dispute resolution process. You must begin this process within 120 days of receiving the bill. For more information or to start a dispute, visit www.cms.gov/nosurprises or call 1-800-985-3059.
This practice is a private pay pediatric speech therapy provider and does not bill insurance. Payment is due at the time of service unless other arrangements have been made. You will be informed of all fees associated with your child’s care, including session rates and any applicable administrative or late cancellation fees.
If you have questions about your estimate or your rights, you may contact our office directly. You may also contact the Texas Department of Insurance Consumer Help Line at 1-800-252-3439 or visit www.tdi.texas.gov for additional support.
By receiving services, you acknowledge your right to a Good Faith Estimate and understand that the estimate provided is not a final bill. Please keep a copy of your estimate and this notice for your records.
Updated: 03/28/2026