01 YOUR RIGHTS
Good Faith Estimate Notice
Your right to an estimate of expected charges when you are uninsured or choosing not to use insurance.
Effective July 24, 2026
About this notice
For purposes of these notices, “we,” “us,” and “our” refer to Felicity, Nurse Practitioner in Psychiatry, PLLC.
This is a patient rights notice, not a price list or an estimate for any particular service.
Your right to an estimate
If you do not have health insurance, or you have insurance but do not plan to use it to pay for an item or service, you have the right to receive a Good Faith Estimate explaining the expected charges for your care.
Felicity, Nurse Practitioner in Psychiatry, PLLC will provide a Good Faith Estimate when federal law requires one after care is scheduled and when an uninsured or self-pay individual requests one.
Requesting and keeping your estimate
You may request a Good Faith Estimate by emailing felicity@felicitynp.com or calling 917-994-9060.
Keep a copy of your estimate. It may be important if you later compare the estimate with a bill or use the federal dispute process.
If a bill is substantially higher
If the amount billed by a particular provider or facility is at least $400 more than that provider’s or facility’s expected charges on the Good Faith Estimate, you may be eligible for the federal patient-provider dispute resolution process.
Eligibility and deadlines are governed by federal rules. For official information, visit CMS information for people who do not have or use insurance or call the No Surprises Help Desk at 1-800-985-3059.
What this notice does not do
This notice does not itself establish a treatment relationship, schedule care, state the cost of a particular service, or guarantee reimbursement from an insurer or any other payer.