Good Faith Estimate | Sequoia Counseling — Fair Oaks, CA
Good Faith Estimate
Transparent pricing and your rights under the No Surprises Act
No Surprises Act
Know what to expect before your first session
Under the No Surprises Act, effective January 1, 2022, healthcare providers are required to give patients who don't have insurance or who are not using insurance an estimate of the expected charges for medical services, including mental health services.
Your rights
What the No Surprises Act means for you
You have the right to receive a Good Faith Estimate
Before your first appointment, you can ask your health care provider for a Good Faith Estimate in writing. This estimate will describe the expected cost of your services, including therapy sessions and any other items or services reasonably expected to be provided.
Make sure your provider gives you a GFE in writing
If you schedule a service at least 3 business days in advance, your provider must give you a GFE no later than 1 business day before the service. If you schedule at least 10 business days in advance, the GFE must be provided no later than 3 business days before the service.
You can dispute a bill that is significantly higher
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill. You may contact the health care provider to let them know the billed charges are higher than the GFE. You can also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS).
Keep a copy of your Good Faith Estimate
Save a copy of your GFE in a safe place. You may need it if you are billed a higher amount and want to dispute the bill.
Our commitment
Transparent pricing, always
At Sequoia Counseling, we are committed to transparent pricing. We will always provide a written Good Faith Estimate before your first appointment if you are uninsured or choosing to pay out-of-pocket. Our care coordinator is available to answer any questions about your estimate or your rights.
Rates
Current session fees
These are our current private pay rates. Your Good Faith Estimate will reflect the services specific to your treatment plan.
| Provider | Service | Rate |
|---|---|---|
| Andrea Diemert, LMFT | Individual Therapy (Talk Therapy) | $220 |
| Andrea Diemert, LMFT | Accelerated Resolution Therapy (ART) | $300 |
| Andrea Diemert, LMFT | Accelerated Resolution Therapy (ART) | $600 |
| Associate Therapists | Individual Therapy | $150–$175 |
Sliding scale fees may be available. Contact us to discuss your options.
Important notice
A Good Faith Estimate is not a contract and does not require you to obtain the items or services listed. The estimate is based on information known at the time of scheduling and may change if your treatment needs change. For questions about your GFE or to request one, please contact our care coordinator.
For more information about your rights under the No Surprises Act, visit cms.gov/nosurprises. cms.gov/nosurprises
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