The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the Good Faith Estimate they get from the provider.
If you don’t have insurance or you self-pay for care, in most cases, these new rules make sure you can get a Good Faith Estimate of how much your care will cost before you receive it. The new law does not prohibit balance billing when an insured patient receives non-emergency medical services at an out-of-network facility, whether furnished by the out-of-network facility or an out-of-network provider.
If you are billed for $400 or more than your Good Faith Estimate, you have the 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 your 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 and Human Services. If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days from the date on the original bill. Make sure to save a copy or picture of your Good Faith Estimate
There is a $20 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 No Surprises Act or call HHS at (800) 368-1019. Your estimate is not a contract. You are not obligated to receive services from me. I can provide you with alternative referrals at your request at any time.
Below is a schedule of standard fees for my services for clients who are self pay.
- Initial diagnostic evaluation-$225
- 50 minute individual video therapy session-$150
- 50 minute family video therapy session-$160
- 50 minute couples video therapy session-$160
- Record Request Administrative Fee-$20-$25
- Good Faith Estimate/Bill Dispute Fee -$25
- Court appearance-$200 per hour