Effective January 1, 2022
Good Faith Estimate & No Surprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, effective 1/1/2022, 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 of 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 wiring 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, visit www.cms.gov/nosurprises or call 1-800-985-3059.
A Note from Dr. Nikki:
My office agreement outlines most of the requirements of this legislation, but a separate document will include the information in a way that complies with this legislation. Anyone new to my practice will receive a copy of this document before scheduling their intake appointment. An updated version will also be provided upon each treatment plan review (approximately every 3 months).
Psychotherapy has unique ethical codes and much of the information required under the new legislation cannot be provided in advance. Anyone new to my practice will be provided with a general document outlining my current full fee schedule for all services, including the billing codes that will be used. This document will be provided before the intake session is scheduled. Since service duration and length are determined collaboratively as part of your treatment, and can change based on the progress the individual is making in therapy, an estimate of therapy costs will be provided as if they are seen on a weekly basis for one year. If you are choosing to pay privately or use out-of-network benefits, I strongly encourage you to reach out to your insurance provider and ask about reimbursement rates for the codes provided. At no time will I speak to an insurance provider.
As it would be unethical to do so, diagnoses are NOT provided before the intake session. Diagnoses are provided after a careful review of clinical symptoms and observations, assessments (when applicable), and collateral information from parents, schools, and additional providers. A diagnosis from another provider does not guarantee the same diagnosis.
After the initial intake, GFEs are reviewed, updated (as needed), and provided whenever treatment plans are updated (approximately every 3 months). You can request an updated GFE at any time.