Insurances / Rates

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care items and services.  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. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059. 

Beginning January 1, 2022, federal laws regulating client care have been updated to include the "No Surprises" Act. Under the law, healthcare providers must give patients who don't have insurance or are not using insurance an estimate of the bill for medical items and services called a "Good Faith Estimate" (GFE), explaining how much your medical care will cost.

This regulation is designed to provide patients with transparency regarding their expected medical expenses and to protect them from surprises when they receive their medical bills. It allows patients to understand how much their health care will cost before they receive services.

Several factors make it challenging to provide an estimate on how long it will take for a client to complete therapeutic treatment, and much depends on the individual client and their goals in seeking therapy. 

Some clients are satisfied with a reduction in symptoms, while others continue longer because it feels beneficial to do so. Others begin to schedule less frequently and may continue to come in for "tune-ups" or when issues arise. Ultimately, as the client, it is your decision when to stop therapy.

At Elevate PD & Therapy, we must provide a diagnosis for all therapy clients for ethical, legal, and insurance reasons (as well as required by the "No Surprises Act"). A formal diagnosis occurs after an assessment has been completed, which will take place 1-5 sessions after beginning psychotherapy. If you choose to decline a formal diagnosis, we will not update the GFE. It is your right to decline a diagnosis per state and federal guidelines.

Elevate PD & Therapy recognizes every client’s therapy journey is unique. How long you need to engage in therapy and how often you attend sessions will be influenced by many factors, including:

• Your schedule and life circumstances
• Therapist availability
• Ongoing life challenges
• The nature of your specific challenges and how you address them
• Personal finances
  

You and your therapist will continually assess the appropriate frequency of therapy. They will work together to determine when you have met your goals and are ready for discharge, or a new “Good Faith Estimate” will be issued should your frequency or needs change.

According to the American Psychological Association, “on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measure”. Additionally, they state that through the working relationship between the client and counselor, sometimes the preference is for “longer periods (e.g., 20 to 30 sessions over six months), to achieve complete symptom remission and to feel confidence in the skills needed to maintain treatment goals”. It depends on several factors because everyone has different, unique counseling goals. 

Like any other relationship, it takes time to develop rapport with your therapist, identify your treatment goals, establish a plan of action, and work towards accomplishing them. Whatever your number of sessions, we will work together to meet your needs.

• The Good Faith Estimate you will receive from your therapist shows the costs of items and services that are reasonably expected for your health care needs. The estimate is based on information known when the estimate was created.
• The 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. Federal law allows you to dispute (appeal) the bill if this happens.
• If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.
• You may contact us at sarah@readytoelevate.org or call 352-345-6218 to let us know if the billed charges exceed the Good Faith Estimate. You can ask us to update the bill to match the Good Faith Estimate, negotiate the bill, or ask if financial assistance is 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 (about four 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, you must pay the price using this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, 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 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Please keep a copy of this Good Faith Estimate in a safe place or take pictures. You may need it if you are billed a higher amount.

Public Disclosure of the Good Faith Estimate