Good Faith Estimate

Notice to clients and prospective clients:

Effective January 1, 2022, a ruling went into effect called the "No Surprises Act," which requires mental health practitioners to provide a "Good Faith Estimate" (GFE) about out-of-network care to any patient who is uninsured OR who is insured but does not plan to use their insurance benefits to pay for health care items and/or services.

 

The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your mental health care needs for an item or service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.

 

You are entitled to receive this "Good Faith Estimate" of what the charges could be for therapy services provided to you. While it is not possible for a therapist to know, in advance, how many therapy sessions may be necessary or appropriate for a given person or family upon the initiation of therapy, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of therapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services from the provider(s) listed, nor does it include any services rendered to you that are not identified here.

This Good Faith Estimate is not intended to serve as a recommendation for treatment or a prediction that you may need to attend a specified number of counseling visits. The number of visits that are appropriate in your case, and the estimated cost for those services, depends on your needs and what you agree to in consultation with your therapist. You are entitled to disagree with the recommendations made to you concerning your treatment and you may discontinue treatment at any time.

 

Egan Counseling & Consulting 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
- personal finances
- therapist availability
- on-going life challenges
- the nature of your specific referral concerns and how you address them

 

You and Dr.Tara Egan will continually assess the appropriate frequency of therapy and will work together to determine when you have met your goals and are ready for discharge and/or a new "Good Faith Estimate" will be issued should the frequency of session(s) or needs change. As related, you may request a new GFE at any time in writing during your treatment.

 

To get more information, go to www.cms.gov/nosurprises or call HHS at (800) 368-1019.

You are encouraged to reach out to Egan Counseling & Consulting. at any time with any questions you may have regarding your treatment plan, or the information provided to you in this Good Faith Estimate at (803-412-1505).