Services We Offer

Good Faith Estimate

The purpose of this document is to make sure that you are fully informed about our fees and financial policies and to comply with a 2022 federal law called the “No Surprises Act.” The intention of this law is to protect consumers from large, unexpected medical bills (e.g., after a hospital visit) in the wake of the COVID-19 pandemic. Under this law, you are entitled to receive this “Good Faith Estimate” of the cost of our services. This estimate is not a contract and does not obligate you to obtain any services from us, nor does it include any additional services that may be recommended during the course of your treatment. In addition, we also explain in this document various important financial policies. Please review it carefully. This estimate is not intended to serve as a recommendation for treatment or a prediction that you may need a specified number of psychotherapy sessions. Indeed, it is not possible for us to know in advance precisely what services you may need or how many sessions may be required. Therefore, this document will simply outline our fees, your potential costs over time, and then review our financial policies. The actual cost of services will depend on your individual circumstances, the type and amount of services we recommend, and the total number of sessions you attend. Of course, you are free to disagree with our treatment recommendations and/or discontinue treatment at any time.

***NOTE: This estimate expires at the end of the current calendar year.***

Financial Policies & Fees:

For all clients, 60 minute sessions of individual, couples, or family therapist cost 

$150 for intake and $120 for regular sessions

Some clients prefer shorter or longer sessions to meet their individualized needs. For those wishing to have shorter or longer sessions, the fee is $60 per 25 minute unit

Per our practice policies, no-shows or appointments cancelled with less than 24-hours notice will be billed the full fee for scheduled services.

If you would like to discuss any charges with your insurance companies, the three billing codes utilized for standard hourly clients are as follows:

• Intake billing code is 90791 
• Regular Clinical Session billing code is 90837 (53 minutes)
• Interactive Complexity billing code is 90785 (this is used when conditions require additional time or expertise in practice) 

A credit or debit card are required to have on file regardless of payment method preferred.

Document Requests:

If a client requests letters, forms, records, or any other form of paperwork to be completed, be advised that there is a fee. These items require time to prepare and deliver, and this takes time away that could be spent with clients. Our rate for preparation and delivery is $100 per hour with a minimum fee of $50. There is also a flat rate of $25 added for printing, shipping, and other office costs. You are able to request an approximate cost to fulfill your records request from your therapist. Once your records are ready, you will receive an itemized invoice with prep and delivery costs. Your records will be sent to you within 5-7 days from the time of your request. We accept cash, checks, and debit/credit cards. 

Court Orders:

If your counselor is subpoenaed or legally required to testify in court, speak with legal officials (including attorneys for either party), or prepare reports for a legal case, a similar fee structure will be charged as that of document requests. You will be charged for each hour that the clinician is unable to see clients due to their need to respond to this request. The charge for this is $100 per hour with a minimum fee of $50 and additional fees of $25 will be added for printing, shipping, and other office costs. An example of charges could be, if your counselor is subpoenaed to testify in court and the proceedings begin at 9:00am and end at 10:00am, you would be charged $300 because the clinician is unable to see clients in the 8 o'clock hour or the 10 o'clock hour due to travel time. If you would like an approximation of the total costs, please request one as soon as possible and your clinician will send you an estimate. 

*In the case the clinician would be required to testify in a custody dispute, these fees will be charged to the parent either requesting the presence of the clinician or the primary parent responsible for the payment of services in the case that the clinician is subpoenaed on behalf of Children Services.*

Payment is due at the time of service and will be collected at beginning of counseling and intake sessions. 

-Our preferred methods of payment are cash and check. We also accept credit, debit, and HSA cards. However, if you use these methods, you will be charged a processing fee based on the total fees of your appointment equal to 3.15% + $0.30.

Example Fee: $120 appointment + $4.08 = $124.08

-If you pay with a bank card, our practice management software will save your information to speed future transactions. We will charge your card for subsequent visits unless you tell us not to do so. If your card information changes, please notify us
as soon as possible.

-If you become unable to pay for services or begin to accrue a balance, discuss this with us as soon as possible. We will work with you to find a solution. If we are unable to come to an agreement, and you continue to maintain an unpaid balance, we
reserve the right to terminate your services and in some cases, send your outstanding balance to a third party collections agency.

Insurance: 

WE ARE CURRENTLY IN THE PROCESS OF SEEKING INSURANCE CREDENTIALING AND WILL UPDATE THIS WITH INSURANCES WE ARE “IN NETWORK” WITH IF AN WHEN THIS BECOMES AN OPTION. 

At this time the practice is unable to bill insurance directly for services but If you would like, I can provide you what’s called a “superbill” that can be self-submitted to your insurance company for reimbursement.  This is an option many people exercise that is frequently accepted by HSAs, traditional insurance, and health share ministries.

Many people do not have the option to refrain from using insurance due to financial constraints.  If this is the case, please reach out and I will happily put you in touch with some other counselors in the area who share similar beliefs to me and would be able to bill your insurance!

We encourage you to discuss with your therapist any questions you might have about our fees and financial policies. In addition, according to the No Surprises Act, you have a right to dispute your bill if the actual amount charged to you substantially exceeds (i.e., by $400 or more) the estimated charges stated in this Good Faith Estimate. Initiating the dispute process will not adversely affect the quality of services rendered to you. To do so, simply discuss the discrepancy with your therapist and point out that the billed charges are higher than the Good Faith Estimate. You have several options:

-Ask that your bill be brought in line with the Good Faith Estimate

-Ask to negotiate the bill

-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 this option, you must start the dispute resolution 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, you will have to pay the higher amount.
To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call HHS at 800-368-1019. We encourage you to keep a copy of this Good Faith Estimate for your records.