Good Faith Estimate

Blue Horse LLC; Counseling & Consulting Notice of Right to Receive a Good Faith Estimate ("Notice")

This Notice was last updated on July 10, 2026.

YOU HAVE THE RIGHT TO RECEIVE A "GOOD FAITH ESTIMATE" OF EXPECTED CHARGES UNDER THE NO SURPRISES ACT.

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychotherapy sessions, assessments, and any additional services, upon request or when scheduling such items or services.

If you schedule a service at least 3 business days in advance, your provider must give you a Good Faith Estimate in writing within 1 business day of scheduling. If you schedule at least 10 business days in advance, you must receive it within 3 business days of scheduling. You can also ask any provider for a Good Faith Estimate before you schedule an item or service; if you do, you must receive it in writing within 3 business days of your request.

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

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers,

email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

Provider Information

Caroline Furcolo, LMHC (RI, NY) | LPC (CT, TX)

NPI: 1437899663

Telehealth services

If you have any questions about this Notice, or would like to request a Good Faith Estimate, please contact us at:

Phone: (401) 594-0663

Email: caroline@bluehorsellc.com