Billing
Good faith estimate
Under the federal No Surprises Act you are entitled to a written estimate of what this will cost, before you schedule.
Last updated July 30, 2026 · Effective July 30, 2026 · Questions: contact@texasemotionalsupportanimalletter.org
Your right
You have the right to receive a good faith estimate explaining how much your health care will cost. Under the No Surprises Act, effective January 1, 2022, health care providers must give patients who are uninsured, or who have insurance but are not using it, an estimate of expected charges for medical items and services.
What you get
- A written estimate, in clear language, of the expected charges for the evaluation and the letter, including any related items or services.
- The estimate covers the total expected cost, not a per-item guess you have to assemble yourself.
- It is not a bill and not a contract. Receiving one does not oblige you to book anything.
When you get it
- You ask for one: within three business days of your request, whether or not you have scheduled anything.
- You schedule at least ten business days out: within three business days of scheduling.
- You schedule three to nine business days out: within one business day of scheduling.
- Anything changes: an updated estimate at least one business day before the service.
We will also tell you about this right verbally when you schedule or ask about cost.
Expected charges
| Service | Total expected charge |
|---|---|
| ESA Letter — up to 2 animals | $129 |
| ESA Letter — 3 or more animals | $199 |
| PSD Letter — up to 2 dogs | $149 |
| PSD Letter — up to 3 dogs | $229 |
| Clarification or revision within 60 days | $0, included |
Each figure is the total expected charge for that service, covering intake review, the telehealth evaluation with a Texas-licensed therapist, and preparation of the letter if the therapist supports it. We charge no separate platform fee, booking fee, records fee or card surcharge. If you ask for a service that is not listed, we will tell you the cost before providing it.
If billed more than the estimate
If you receive a bill that is at least $400 more than your good faith estimate, you may dispute it through the federal patient-provider dispute resolution process. Start the dispute within 120 calendar days of the date on the bill. Using the process does not affect the quality of your care, and we will not retaliate.
How to request one
Email contact@texasemotionalsupportanimalletter.org or email contact@texasemotionalsupportanimalletter.org and ask for a good faith estimate. There is no charge for it and you do not have to book anything. We can provide it in large print or plain text, and in [languages you support] on request.
For more information about your rights under the No Surprises Act, visit the Centers for Medicare and Medicaid Services, or call the federal help line.