Good Faith Estimate

In compliance with the No Surprises Act that goes into effect January 1, 2022, all
healthcare providers are required to notify clients of their federal rights and
protections against “surprise billing.”
This Act requires that we notify you of your federally protected rights to receive a
notification when services are rendered by an out-of-network provider, if a client
is uninsured, or if a client elects not to use their insurance to pay for services,
including psychotherapy services.
You have the right to receive a Good Faith Estimate for the total expected cost of
any non-emergency healthcare services, including psychotherapy services. It is
difficult to determine the true length of treatment for mental health care, and
each client has a right to decide how long they would like to participate in mental
health care. Therefore, your Good Faith Estimate will include a fee schedule for
the services typically offered by your therapist, and we will collaborate with you
on a regular basis to determine how many sessions you may need.
You can ask your health care provider, and any other provider you choose, for a
Good Faith Estimate before you schedule a service, or at any time during
treatment.
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,or
how to dispute a bill, see your Estimate, or visit www.cms.gov/nosurprises

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