Under the No Surprises Act beginning January 1, 2022, healthcare providers provide patients who don’t have insurance or who are not using insurance a “good faith estimate” of the bill for medical items and services.
At Interleaf Counseling Services, I value transparency with the cost of services that provided. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes psychotherapy and related costs like psychological assessments, client requests for services outside of session time (for accommodation letters, phone calls, coordination of care with ancillary providers, etc.)
I will collaborate with you regarding your care to determine how many sessions and/or additional services are needed to receive the greatest benefit based on your clinical concerns. Although each client varies in their care with regard to session frequency and length of the therapeutic relationship, I typically see clients for a minimum of 2-3 months (on a weekly or biweekly basis) to establish a foundation of who you are, what your therapy goals are, and working towards those goals.
Interleaf Counseling Services will give you a Good Faith Estimate in writing at least 1 business day before you begin services. You can also ask Interleaf Counseling Services and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
At this time, I only accept self-/ cash-pay and do not bill insurance carriers for therapy services. These are the following services that may be billed directly to you:
90791 - Intake Assessment ($175 - individual, $200 - couples) x 1 dates of service
90837- 45-50 minute Individual Session ($150)
90847 –Couples Session ($175)
90853 - Group Therapy ($50)
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
You may also 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.
Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.
Visit https://www.cms.gov/nosurprises for more information about your rights to a Good Faith Estimate.