What is a “Good Faith Estimate”?
As required by federal law, each client of Fletcher Therapy receives a document called a Good Faith Estimate. What is that, exactly?
Beginning January 1, 2022, federal laws regulating client care have been updated to include the “No Surprises” Act. This Act requires health care practitioners to provide current and potential clients a “Good Faith Estimate” (GFE) on the cost of treatment.
This new regulation is designed to provide transparency to patients regarding their expected medical expenses and to protect them from surprises when they receive their medical bills. It allows patients to understand how much their health care will cost before they receive services.
It is challenging to provide each client an estimate on how long it will take for you to complete treatment. So much depends on the individual client and their goals in seeking therapy. Some clients are satisfied with a reduction in symptoms while others continue longer because they find it beneficial. Others begin to schedule less frequently, and may continue to come in for “tune ups” or when issues arise. As the client, it is your decision how often to attend therapy sessions and when to stop therapy.
Established clients who began treatment before January 1, 2022 and new clients will receive a Good Faith Estimate (GFE). The GFE will be available to you in writing, accessible through the Simple Practice Client Portal.
I have listed below my current full price session fees, along with my best estimate for a 12 month period with differing types of sessions scheduled. If you are in couple/family therapy, a sliding scale client, or schedule sessions of longer duration than the standard 50 minutes, your estimate will naturally vary. I am happy to discuss this with you at any time, to ensure you never have unexpected charges on your bill.
Good Faith Estimate Details & Examples
Individual 50-minute session $185.00
Couple/Family 50-minute session $200.00
Weekly individual 50-minute sessions for 50-weeks $9,250.00
Bi-weekly individual 50-minute sessions for 50 weeks $4,625.00
The above examples are provided to give an idea of the financial expectations for a calendar year.
How can you find your exact total? Simply multiply the number of sessions by the hourly rate. The frequency and duration are dependent on your individual needs and goals.
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.
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 expected charges for medical services, including psychotherapy services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.
You can ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule a 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.
If you believe you’ve been wrongly billed, you may contact:
- The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
- The California Department of Managed Health Care at 1-888-466-2219 or visit https://dmhc.ca.gov/portals/0/healthcareincalifornia/factsheets/fsab72.pdf for more information about your rights under California law.
- The California Department of Insurance at 1-800-927-4357 or visit https://www.insurance.ca.gov/01-consumers/110-health/60-resources/NoSupriseBills.cfm for more information about your rights under California law.
I look forward to talking with you and answering any questions you may have about the “No Surprises” Act and Good Faith Estimates.