Good Faith Estimate
Your Right to a Good Faith Estimate: Haven Counseling Services PLLC
Under the No Surprises Act, individuals who do not have health insurance or who choose not to use their insurance to pay for healthcare services have the right to receive a Good Faith Estimate explaining the expected cost of their care.
What Is a Good Faith Estimate? A Good Faith Estimate provides information about the expected charges for healthcare services before those services are provided. If you are uninsured or paying for services yourself without using insurance, you have the right to receive a Good Faith Estimate when scheduling eligible services or upon request.
Fees for Services: Current fees at Haven Counseling Services include:
Individual Therapy, 50 minutes: $200
Extended EMDR Session, 80 minutes: $320
Therapy Intensive Package: $1,350
These listed fees are for general information and do not replace an individualized Good Faith Estimate. The total cost of therapy depends on the services provided, the frequency of sessions, and the duration of treatment.
Your Rights: You have the right to receive a Good Faith Estimate in writing. If you schedule healthcare services at least three business days in advance, you generally have the right to receive an estimate before your appointment. You may also request an estimate before scheduling. If you receive a bill that is at least $400 more than your Good Faith Estimate, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process. You generally must begin that dispute within 120 days of receiving the bill.
Receiving a Good Faith Estimate does not require you to receive services from the provider.
Request an Estimate: To request a Good Faith Estimate for services at Haven Counseling Services, please contact: Jaclyn Rubbo, LMFT, Haven Counseling Services PLLC jaclyn@havencounselingservices.org
For additional information about your rights under the No Surprises Act, visit: https://www.cms.gov/nosurprises