16944 Ventura Blvd., Suite 11 - Encino, CA 91316 - (818) 216-0243

Mary M. Manix, Psy.D.

Clinical Psychologist, License # PSY 18751

Good Faith Estimate 2022


"Right to Receive a Good Faith Estimate of Expected Charges"

Good Faith Estimate – No Surprises Act 2022

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers must give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical services. This applies to "cash pay" as this provider is “out of network” on insurance panels.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

16944 Ventura Blvd., Suite 11 - Encino, CA 91316 - (818) 216-0243 - PSY 18751
© Mary M. Manix, Psy.D. All rights reserved.