Your Right to a “Good Faith Estimate”
What is the No Surprises Act?
Under Section 2799B-6 of the Public Health Service Act, we required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in an insurance plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage. The information in the good faith estimate is only an estimate. Actual services or charges may differ from the good faith estimate. The good faith estimate is not a contract and does not require you to obtain the services from us.
Financial estimates for care prior to an initial diagnostic session are difficult to calculate. However, generally speaking, most patients experiencing distress requiring psychotherapy services with an accompanying ICD-10/DSM diagnosis should plan for weekly therapy visits at your therapist’s quoted rate. This rate will be made available to you in an initial email when scheduling and in your intake packet if you decide to schedule with us. Naturally, given your presenting concerns, diagnosis, level of distress, treatment goals, and availability, the frequency of sessions might increase or decrease from this estimate. Additionally, your therapist might recommend additional services as part of the course of care that must be scheduled or requested separately and are not reflected in the good faith estimate, such as psychological assessments. They will discuss any foreseeable changes to this estimate with you.
If you are billed more than this good faith estimate, you have a right to dispute the bill. To do so, please contact us to let us know that 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. 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 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 Berkshire Therapy Group, 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 1-877-696-6775.