Good Faith Estimate Notice
What is a Good Faith Estimate, and what can clients expect from The Feelings Healers?
What is the No Surprises Act?
The No Surprises Act aims to increase price transparency and reduce the likelihood that clients receive a “surprise” medical bill by requiring that providers inform clients of an estimated expected charge for a service before the service is provided.
Starting January 1, 2022, state-licensed or certified health care providers, including behavioral health care providers, like us are required by law to give uninsured and self-pay clients a good faith estimate of costs for services when scheduling care or when the client requests an estimate.
The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
What does this mean for clients of The Feelings Healers?
- We will continue to make our hourly rates transparent — as has been our practice.
- LPC/LCSW/LMSW: $175/hour
- LPC Associate: $115/hour
- Therapist Intern: $65/hour
- If you do not have or do not plan to use your insurance benefits for care, you will receive a Good Faith Estimate for Health Care Items and Services, which can be found in your Simple Practice Portal.
- We already regularly review clients’ treatment plans — now, we will add renewing your Good Faith Estimates as part of that practice. Should your need for services change, e.g. moving from twice a week sessions to weekly, your Good Faith Estimate will be updated.
- In some cases, we may recommend additional services from another provider that would not be included in your estimate from TFH.
- You have a right to request a hard copy of the Good Faith Estimate, and you have a right to engage in a dispute resolution process if the actual costs of services included in your estimate significantly exceed what is in the estimate.
- The Good Faith Estimate is NOT a contract.
While surprise costs are not something we generally encounter in our practice, you should know that your Good Faith Estimate will not include any unknown or unexpected costs that may arise during treatment. However, if you are billed for significantly more than your Good Faith Estimate for the services indicated on the estimate, you have the right to dispute the bill using the following dispute resolution options:
What if I need to dispute my Good Faith Estimate?
- Contact us and let us know the billed charges are higher than the Good Faith Estimate. You can ask us to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
- Start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
- There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
To learn more and get a form to start the process, go to contact http://www.cms.gov/nosurprises or call HHS at (800) 368-1019.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit http://www.cms.gov/nosurprises or call (800) 368-1019.