TESSERA

Psychiatry

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NOTICE OF YOUR RIGHT TO RECEIVE

A GOOD FAITH ESTIMATE

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Effective date: 07/13/2026

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You have the right to receive a Good Faith Estimate explaining the expected cost of your care.

Federal law generally requires health care providers to give patients who do not have certain health coverage, or who choose not to use their coverage, a written estimate of expected charges before non-emergency care is provided.

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Your rights

• You may request a Good Faith Estimate at any time, including before scheduling.

• For care scheduled 3–9 business days in advance, TESSERA will provide the estimate within 1 business day after scheduling.

• For care scheduled 10 or more business days in advance, TESSERA will provide the estimate within 3 business days after scheduling.

• If you request an estimate before scheduling, TESSERA will provide it within 3 business days.

• The estimate will list charges reasonably expected for services TESSERA anticipates providing, based on information known at the time.

• If a final bill from TESSERA is at least $400 more than TESSERA’s estimate, you may be eligible for the federal patient-provider dispute resolution process.

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About estimates from TESSERA Psychiatry

TESSERA Psychiatry is a private-pay, fully virtual outpatient psychiatry practice for adults age 18 and older who are physically located in Texas at the time of care. A Good Faith Estimate is not a bill, does not require you to receive care, and does not guarantee a particular treatment plan or number of visits.

The estimate is based on information available when prepared and may not include unanticipated services that were not reasonably expected. TESSERA may issue an updated estimate if the expected course of care changes.

 

Request an estimate

Email: contact@tesserapsychiatry.com

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Do not send detailed medical information through a general contact form or unsecured email.

Federal assistance

Website: cms.gov/nosurprises/consumers

Email: FederalPPDRQuestions@cms.hhs.gov

Help Desk: 1-800-985-3059

 

Garcia Psychiatry & Wellness, PLLC d/b/a TESSERA Psychiatry