Good Faith Estimates and the No Surprises Act: What you need to know
1. A good faith estimate is required for clients who are self-pay or who do not have insurance.
The good faith estimate is meant to protect you from surprise medical bills or surprise costs.
Quite frankly, counseling and therapy ethics (and my own moral compass) already dictate that the cost of every session is known before the session starts. Session costs will never change without a conversation first, and we establish an agreed upon cost per session in our first conversation. Our first conversation is also free.
In addition to our agreement regarding individual cost, I will provide a ‘good faith estimate’ that outlines the expected costs for 6-12 months in therapy. I also provide a worksheet in which you can calculate what therapy will cost you over time. The estimate will expire after a year.
2. You’ll receive the estimate after our initial consultation (which is free) with the rest of your paperwork.
After we’ve agreed upon your session fee, you’ll receive a ‘good faith estimate’ via your Client Portal. You will be able to access this document at any time by re-visiting your Client Portal. If you are paying with insurance, you will not receive this estimate.
The estimate will be sent within three days of scheduling our first session.
3. You’ll receive a new estimate any time session cost changes or when the current estimate expires.
If a session fee goes up - or down - you’ll receive a new estimate for the remainder of that calendar year. Estimates are good for one year from receipt (this date will be in the estimate you receive).
4. You can dispute your bill if your cost exceeds the estimate by $400 or more.
The No Surprises Act is meant to reduce surprise medical bills; thus, it also allows an avenue for recompense if you do receive a surprise medical bill.
5. You should never receive a surprise bill from a therapist or counselor regardless!
Our ethics state that clients should know, upfront, the cost of a session, before you consent to attending the session. This is part of consent to therapy. The cost of session is included in your paperwork.
If you don’t know the cost of session, talk to your therapist before session starts. They need to make sure you understand the costs, even when you are using insurance. For example, even when my insurance clients have a copay, I tell them the full contracted rate that they could be responsible for if their insurance refers to pay for some reason. Otherwise, they have not consented to the potential cost of therapy, and that is unethical.
