Under the No Surprises Act, you have the right to receive a "Good Faith Estimate" explaining the expected cost of your care when you do not have insurance or choose not to use insurance.

Your Rights Under the Law:

• You have the right to receive a Good Faith Estimate in writing at least one business day before your scheduled service.
• This estimate will include the total expected costs of services provided by Dr. Tatsiana Razzhavaikina, PhD, Licensed Psychologist.
• You may request a Good Faith Estimate before scheduling an appointment.

Billing Protections:

• If you receive a bill that is at least $ 400 more than your Good Faith Estimate, you can dispute the charge.
• Keep a copy of your Good Faith Estimate for your records.

For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 402−770−3895