Good Faith Estimate
for Cognitive Clarity
Our Policies
Effective Date: January 1, 2025
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Your Rights and Protections Against Surprise Medical Bills
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
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Your Good Faith Estimate
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
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Payment Policy
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All payment is due at the time of service and is based on the time spent during the session.
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Each clinician may have different rates, and all rates will be shared at the beginning of the counseling relationship.
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If you choose to use insurance, you are responsible for the balance that the insurance company does not cover. It is very important that you check your benefits before we start counseling and inform your therapist if you have secondary insurance.
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Estimated Costs (Therapist may have different rates)
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Initial Assessment (60 minutes): $100-200
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Individual Therapy Session (45 minutes): $100-200
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Couples Therapy Session (60 minutes): $150-250
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Family Therapy Session (60 minutes): $100-200
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Group Therapy Session (90 minutes): $30-75
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Administrative Work, Phone Consultations: $25-500
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Disclaimer
This Good Faith Estimate does not include any unknown or unexpected costs 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 (appeal) the bill.
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If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill. You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
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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 (about 4 months) of the date on the original bill.
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Contact Information
If you have any questions about this Good Faith Estimate or if you need more information, please contact our office.
