No Surprises Act and Good Faith Estimate
No Surprises Act and Good Faith Estimate
Under Section 2799B-6 of the Public Health Service Act www.cms.gov/nosurprises
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.
Providers and facilities must:
Provide the good faith estimate before an item or service is scheduled, within certain timeframes.
Within 3 business days of an appointment scheduled;
If a good faith estimate is requested, it must be provided within 3 business days.
Offer an itemized list of each item or service, grouped by the provider or facility offering care. Each item or service has to have specific details, like the health care code assigned to it and the expected charge.
Explain the good faith estimate to you over the phone or in-person if you request it, and then follow up with a written (paper or electronic) estimate.
Provide the good faith estimate in a way that’s accessible to you.
Once you receive a good faith estimate from your provider or facility, be sure to keep it in a safe place so you can compare it to any bills you get later. View an example of what a good faith estimate (PDF) may include . If you’ve had your service and find that the billed amount is at least $400 above the good faith estimate, you may be eligible to start a patient-provider dispute resolution process. Learn more about the dispute resolution process, including eligibility requirements and what information or documents you need to start a dispute. The cost to get the dispute process started is $25.
Healthcare providers are required to provide clients who do not have insurance or who choose not to use their insurance for therapy services with an estimate of the cost of those services. The total cost for each client will vary depending upon the length of time and frequency of sessions that occur throughout the therapeutic relationship as determined by the initial assessment and continued evaluation of treatment needs and progress. A detailed list of possible services is provided. This estimate will be valid for the next twelve (12) months. Should any fee changes occur, or upon your request, Open Heart Counseling of Austin PLLC will provide you with a new good faith estimate.
https://www.cms.gov/nosurprises
https://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing
The information provided here is for general informational purposes and not intended to serve as legal advice or opinion.Whatever it is, the way you tell your story online can make all the difference.
Clinical Services
I provide EMDR therapy, play therapy, sandtray therapy, expressive arts therapy, and talk therapy. I offer a limited number of sliding scale appointments in order to increase access to services. If you are in need of reduced rate, please let me know and we can discuss availability and rates in our initial consultation call. Availability is not guaranteed. Fees for therapy services are as follows:
Intake session fee (initial session): $225.00
Standard session fee (after the initial session) and parent consultation: $180.00 per session
Standard sessions and parent consultations are 50 minutes in length.
Play Therapy sessions are 40-45 minutes in length.
Sessions over 60 minutes shall be charged $45.00 for each additional quarter hour; billed in whole quarter hour increments.
EMDR Intensive fees: $270 for 90 minutes and $360 for 120 minutes
Group therapy fee: $60 for 90 minutes
Fees for Non-Clinical Services
Consultation with another professional or provider (psychiatrist, medical doctor, school faculty, etc.) that exceeds 20 minutes is billed at a rate of $45 for each fifteen minute increment.
Appointments cancelled at least 24 hours prior to the appointment: $0
Missed appointments or appointments canceled less than 24 hours prior to appointment: $180
Court related costs are billed at a rate of $360 per hour. What qualifies as a court related cost is detailed in the initial intake appointment and outlined in the informed consent agreement. Court related work is also subject to an initial retainer equal to 6-24 hours billed at a rate of $360 per hour. The number of hours used to calculate the retainer is dependent upon the distance required for travel and detailed in the informed consent agreement.
EMDR Consultation and Supervision Services
As an LPC Supervisor and an EMDRIA Consultant in Training I provide supervision for licensure and consultation to help advance EMDR skills or work toward EMDR Certification. In addition to these services I provide professional consultation to therapists in my areas specialization: neurodivergent affirming care, childhood trauma, attachment disruption and trauma, mood dysregulation, parenting, collaborating with schools, and more.
LPC Supervision Fees
$120 per individual hour (can include 2 supervisees)
$160 for 2 hours of group supervision (3-6 supervisees)
EMDR Consultation Fees
$50 per group hour
$100 per individual hour
Professional Consultation Fees
$120 per hour
Sessions that go beyond one hour will be billed at an additional $30 per quarter hour
