At Elevate Psychotherapy, we are committed to providing clear information about the cost of therapy. Under the No Surprises Act, individuals who do not have health insurance or who choose not to use their insurance to pay for services are entitled to receive a Good Faith Estimate of expected charges.

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What Is a Good Faith Estimate?

A Good Faith Estimate provides an estimate of the expected cost of health care services you are scheduled to receive. It is not a bill and does not guarantee the final cost of services.

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Your Good Faith Estimate

For clients who are uninsured or whose health insurance plan is out-of-network with Elevate Psychotherapy, our current out-of-pocket fees are provided as part of the intake process.

Because the frequency and duration of psychotherapy vary based on individual needs, treatment goals, and clinical recommendations, the total cost of treatment cannot be determined in advance. Your Good Faith Estimate will reflect the services reasonably expected at the time the estimate is prepared.

You may request a Good Faith Estimate at any time. If you are scheduled to receive services, you will receive an estimate within the timeframes required by federal law.

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Other Potential Charges

Additional charges may apply for services outside of regularly scheduled psychotherapy sessions, including certain administrative or legal services. Any applicable fees will be discussed with you in advance when possible.

Late cancellation and missed appointment fees are separate from the cost of scheduled health care services and are described in the Client Services Agreement.

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Your Right to Dispute a Bill

If you are uninsured or your health insurance plan is out-of-network with Elevate Psychotherapy, and your final bill is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.

For more information about your rights under the No Surprises Act or to learn how to initiate a dispute, visit the U.S. Department of Health and Human Services website.

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Questions or Requests

If you have questions about your Good Faith Estimate or would like to request an estimate, please contact:

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Elevate Psychotherapy

Charlotte Howson, Psy.D., Owner

drhowson@elevatetherapy.online

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