Good Faith Estimate for Counseling

All my counseling clients have a right to receive a Good Faith Estimate per federal law as of January 1, 2022.

A Good Faith Estimate enumerates the expenses you can reasonably expect to pay for your mental health care services provided by me and my counseling practice.

This estimate is created based on the infomation known to me at the time the estimate is first created. It does not include unknown or unexpected costs tht may arise during treatment. It is possible you may incur more charges than the estimate enumerates if complications or special circumstances arise. If this happens, the federal law provides you a right to dispute your bill. If you are billed for $400 or more than your Good Faith Estimate, you have a right to dispute the bill.

You may contact me directly if you are billed charges that exceed the Good Faith Estimate. You can request for me to update our bill to match the Good Faith Estimate, request to negotiate the bill, or you may request information about financial assistance availability.

You also have the right to initiate a dispute resolution process with the U.S. Department of Health & Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process with 120 calendar days from the date on the original bill.

There is a $25 fee to use the dispute process.

If the dispute-reviewing agency agrees with you, you will be responsible for the amount provided on your Good Faith Estimate.

If the agency disagrees with your dispute and agrees with the fees charged by me that exceed the Good Faith Estimate, you will have to pay the higher amount charged.

To learn more visit https://www.cms.gov/nosurprises or call (800)368-1019.

Your estimate is not a contract. You are not obligated to receive services from me. My office can provide you with alternative referrals at your request at any time.

One hour of client session time is provided at a cost of $150 per hour.