Right to Receive a Good Faith Estimate of Expected Charges
Under the No Surprises Act

This notice provides you with my best understanding of your rights under a new (and confusing) federal law called the No Surprises Act. My practice has always communicated openly about fees and policies, but this new law requires that I post notification on my website about my legal obligation to talk with you openly about fees and give you an understanding of the cost of therapy. Please feel free to contact me with any questions.

Under this new federal law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services. The following statements may not apply to psychotherapy, but I share them with you to be in compliance with the law.

• 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 one 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.

Please note that in my practice, I will take care of all filing for insurance, unless you prefer to file on your own. This is a service I provide. In estimating the cost of any therapy, you will need to apprise yourself of your insurance deductible or the amount you might expect to be reimbursed from your insurance. Sometimes this amount is elusive until after I do the filing. I will report to you in a timely way anything I learn about what your insurance will offer to you.