No Surprises Act & Good Faith Estimates

In compliance with the No Surprises Act that went into effect January 1, 2022, I am required to notify all clients of your Federal rights and protections against surprise billing.

This Act requires that I notify you of your federally protected rights to receive a notification when services are rendered by a non-participating provider and provide options to receive care from an in-network provider if one is available.

Please click here for my Disclosure on Surprise Billing.

These rights are also outlined at https://www.cms.gov/nosurprises/ and particularly at https://www.cms.gov/nosurprises/consumers/new-protections-for-you .

Clients Forgoing Use of Their Insurance or Uninsured: I am required to forward you a Good Faith Estimate shortly before our first session.  You are under no obligation to sign it (and I can help you find an in-network provider) but I will need to decline treatment if we do not sign an agreement.

Odd Fit of this Act Applying to Psychotherapy:
Psychotherapists in private practice were under the impression that this Act would not apply to us — we thought it would only apply to big hospitals as the intent of the Act was/is mainly to keep people at hospitals from getting huge surprise bills. 

A realistic preview of what the entire length of therapy will cost is practically impossible ahead of time. Providing a per session fee is reasonable and already ethically required. Speed of response to treatment, frequency of treatment, severity of condition, changing client goals, the value of ongoing support, and more all effect ultimate costs. Psychotherapy is not a one-time procedure like a broken arm that can be easily quoted — and physical medical procedures were what the Act originally aimed to apply to.

Under certain circumstances, clients can enter a dispute resolution process if costs go too high above the Good Faith Estimate (GFE). Therefore, I need to quote a GFE for an entire year with the highest likely costs factored in. While this has the advantage of helping clients think through and budget for longer-term therapy, it can also force sticker shock on potential clients right at the time when they are most in crisis — possibly causing them to forgo the help they need. Many/most clients see relief of their original condition far faster than a year, and if they stay that long its because they are finding value working on secondary or different concerns. Clients always have the right to discontinue therapy at any time they are worried about their budget, or discuss budgeting options with their therapist.

Clients paying out-of-pocket for therapy will be given GFE based upon my Standard Fee Schedule. Financial discounts are available on a limited basis.