Good Faith Estimate
Effective January 1, 2022
The No Surprise Act provides clients/patients rights and requires all medical facilities and mental health providers to provide you a good faith estimate for your total care with our practice and to make sure you know that you can use your medical insurance (if you have any) with an in-network provider if you so choose. Crain Counseling complies with the No Surprise Act and is considered an out-of-network provider with all insurance boards. We are up front about expected costs and believe in cost transparency.
Mental health care costs are more difficult to calculate than traditional medical care. That being said, understanding an estimate given prior to care is an estimation of cost prior to diagnosis and treatment planning. Please note this estimate is for a 12-month period for weekly counseling needs and cannot factor in all the unforeseen circumstances.
Additionally, all invoices will be made available to you upon scheduling of services. This should support price transparency with your good faith estimate. Payment for services will not be due until the time of your appointment, but your account will estimate for all upcoming appointments.
I firmly believe that finances can cause anxiety or may cause doubt for you pursuing care for yourself and/or your family. Our desire has always been to find ways for individuals to access self-care. If you have further questions about this estimate or your rights under the No Surprise Act, please see the FAQ page below or reach out to me for further questions.
Good Faith Estimate FAQ
“What are my rights under the No Surprise Act”
- 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 healthcare 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, complaints or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
“Is the Good Faith Estimate changing the amount of money I’m paying per session?”
Nope! Our amounts are the exact same. It’s just presenting the information to you in a different way. You’ve had access to this information from the portal throughout our treatment and you are always free to look back on your bank/card statements too. But no, it will not change the amount you are charged each time we meet.
“Does anyone get access to this information? Do you have to report it to anyone?”
Nope! This is all still between just an internal document at Crain Counseling. This is still protected health information so only your written permission allows Crain Counseling to share this with anyone.
“Can I still submit Crain Counseling super bills to my insurance for them to cover part of my bill with my OON benefits?”
Yes, you can! That will not change at all. The Good Faith Estimate is a way to ensure you are getting the information about the cost of care. You will still submit the individual super bills (for each session) yourself directly to your insurance company.
“Why is my total so high?”
Remember, this is only an estimate not a bill or contract. You can end therapy at any time or adjust your schedule according to your financial needs. And since it’s hard to predict exactly how many times you will want a session, this number can go down as you progress through treatment. There may be times you are on vacation, your counselor is not available, or you want to spread out sessions.
“If I think that I’m being charged more than what is written here do I bring that up with my counselor?”
Yes, please do! They can go through the charges and see what they have looked like over time If you are unable to resolve things with your counselor please contact our offices.
“How do you come up with the length of treatment/number of sessions?”
Crain Counseling bases care plans on assessment, treatment goals, and treatment progress identified with your counselor. Historically individuals will benefit from weekly appointments and move toward spreading out services over time. If you have questions or concerns about the length of treatment or frequency of treatment please speak with your counselor.
“Does the No Surprise Act apply to all healthcare settings or just for Crain Counseling?”
The No Surprise Act applies everywhere, so this will more than likely become routine paperwork when you receive medical care going forward.
“Can I read about the Good Faith Estimate anywhere?”
Yes! On the paperwork provided, you will find all the links as well as a phone number to call if you would like to research this Act for yourself.