Good Faith Estimate (No Surprise Act)
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This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created, and does not include any unknown or unexpected costs that may arise during treatment.
Throughout your treatment, we may recommend additional items or services as part of your treatment that are not reflected in your Good Faith Estimate. These would need to be scheduled separately with your consent and the understanding that any additional service costs are in addition to the Good Faith Estimate.
If your needs change during treatment, we will supply a new, updated Good Faith Estimate to reflect the changes to treatment, and the accompanying cost changes.
You may contact us to let us know if the billed charges are higher than the Good Faith Estimate. You can ask us to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
The Good Faith Estimate is not a contract between the provider and client and does not obligate or require the client to obtain any of the listed services from the provider.
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Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for mental health services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care services.
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15 minute consultation : $0 (15 minutes)
Soul Sessions (Talk Therapy): $130.00 per session (50 minutes)
Soul Sessions (Talk Therapy): $70 per session (30 minutes)
Tarot for the Tenderhearted (Tarot Therapy): $150.00 per session (60 minutes)
The Exhale (Talk Therapy + Yoga + Sound Healing): $160 per session (75 minutes)
From Soul to Somatic (Tarot Therapy + Yoga + Sound Healing): $180 per session (75 minutes)
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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.
To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call HHS at (800) 985-3059.
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For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call (800) 985-3059.