No Surprises Act and Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
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. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
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 or call 800-985-3059.
My standard therapy fee is $140 per clinical hour (53-minute session). An income-dependent sliding scale is available in limited numbers and may reduce this rate; please let me know if you wish to apply. Group therapy rates are generally lower, and vary by type of group.
Depending on your health insurance provider or employee benefit plan, it is possible for services to be covered by your insurer in full or in part. I am able to work directly with some insurance companies for compensation. For the others, I am able to provide a “super bill” to the client for your use in seeking reimbursement from your insurer. My insurance credentialing is currently in progress; please check with me for the latest updated status.
The insurance process can be difficult to navigate. I recommend that you contact your insurance provider to verify how your plan compensates you for psychotherapy services. Ask these questions to help provide clarity regarding your coverage:
- Does my health insurance plan include mental health benefits?
- Is my provider in-network with my insurance?
- If not, are out-of-network behavioral health services reimbursable under my insurance plan? At what rate? What is the process for making this claim?
- Do I have a deductible? If so, what is it and have I met it yet? Do I have co-insurance? What are my maximum annual out-of-pocket expenses?
- Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
- When does my insurance calendar year reset?
- Do I need written approval from my primary care physician in order for services to be covered?
Session fees may be paid using cash, checks, and all major credit cards. Payment will be arranged directly through my electronic health record system when you complete your intake paperwork.
If you are unable to attend a session, please be sure to cancel at least 24 hours beforehand. Otherwise, you may be charged the full rate for the session.
Please contact me for any additional questions you may have regarding billing, insurance, and fee policies.