Clients sometimes request additional services and there are charges for these services, such as document copies, cancellation fees, etc. the charges for these are outlined in your intake paperwork and are not included in a Good Faith Estimate as they are non-standard and unpredictable from the therapist / scheduler perspective.
Requesting a Good Faith Estimate:
Healing with Grace Counseling Center will be happy to provide you with a written Good Faith Estimate at any time. All you have to do is ask your therapist. Your Good Faith Estimate will show the costs of items and services that are reasonably expected for your health care needs. The estimate is based on information known at the time the estimate was created. Your Good Faith Estimate doesn't include any unknown or unexpected costs such as those mentioned above, that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute the bill.
Your right to dispute the bill:
You may contact the health care provider to let them know the billed charges are higher than your Good Faith Estimate. You can ask them to update the bill to match the Good faith Estimate, or ask to negotiate the bill. 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 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 your Good Faith Estimate.. If the agency disagrees with you and agrees with the health care provider, you will have to pay the higher amount.
To learn more and get a form to start the process, or for more information about your rights to a Good Faith Estimate, or the dispute process, go to: www.cms.gov/nosurprises or call HHS at: (800)368-1019. Keep a copy of your Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed the higher amount.