No Surprises Act

Shared Smile Behavioral Health PLLC

Effective Date: April 2, 2026

Your Rights and Protections Against Unexpected Medical Bills

When you receive care from Shared Smile Behavioral Health PLLC, you are protected under the No Surprises Act. This law helps ensure that you understand the cost of your care in advance and are not unexpectedly billed.

Self-Pay (Cash-Pay) Patients

As a self-pay practice, we do not bill insurance. If you do not have insurance or choose not to use it, you have the right to:

  • Receive a Good Faith Estimate of expected charges before your care begins
  • Ask for a Good Faith Estimate at any time before scheduling services
  • Understand the expected cost of services in advance

Good Faith Estimate

A Good Faith Estimate is a written document that outlines the expected costs of your care.

You will receive a Good Faith Estimate:

  • After scheduling a service, or
  • Upon request

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

How to Dispute a Bill

If you believe your bill is significantly higher than your estimate, you may:

  • Contact us directly to discuss the charges
  • Initiate a dispute resolution process through the U.S. Department of Health and Human Services (HHS)

You must start the dispute process within 120 calendar days of the date on your bill.

For more information, visit:
https://www.cms.gov/nosurprises

Questions or Requests

If you have questions about your estimate or would like to request one, please contact:

Shared Smile Behavioral Health PLLC
Email: [email protected]
Phone: 703-755-0953

Serving Virginia & Maryland (Telehealth)

View Services in Maryland View Services in Virginia

Commitment to Transparency

We are committed to clear, upfront communication about the cost of your care. If you have any questions, we encourage you to reach out at any time.

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