No Surprises Act & Good Faith Estimate

Under the No Surprises Act (Section 2799B-6 of the Public Health Service Act), clients who do not have insurance or who choose not to use insurance have the right to receive a Good Faith Estimate explaining the expected costs of non-emergency services.

More information is available at: www.cms.gov/nosurprises. Your Rights Under the LawYou are entitled to:

A Good Faith Estimate of the total expected cost of therapy services before treatment begins.
An estimate that includes all related costs, if applicable (e.g., services, tests, or other health-related fees).
A written estimate at least 1 business day before your scheduled service.
The option to request a Good Faith Estimate at any time before scheduling.
The right to dispute a bill if the final amount is $400 or more above the provided estimate.

Please save a copy of your Good Faith Estimate for your records

Provider Responsibilities As a provider, I am required to:

Provide a Good Faith Estimate within 3 business days of scheduling a service.
Provide an estimate within 3 business days if you request one without scheduling.
Offer an itemized list of services, including service codes and expected charges.
Explain the estimate verbally if requested and follow up with a written copy (paper or electronic).
Ensure the estimate is delivered in an accessible format.

If your actual bill is at least $400 higher than the estimate you received, you may start a patient–provider dispute resolution process. The fee to initiate this process is $25. More information can be found here: https://www.cms.gov/nosurpriseshttps://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing

Good Faith Estimate for Therapy Services

Clients who self-pay or decline to use their insurance will receive a Good Faith Estimate outlining expected costs. Total cost varies based on session frequency, length, and your individualized treatment plan. Your Good Faith Estimate is valid for 6 months. If fees change or you request an updated estimate, I will provide a new Good Faith Estimate.

Disclaimer: This information is provided for general informational purposes only and does not constitute legal advice.