top of page
Crisis Hotlines

National Suicide Prevention Lifeline: 800-273-8255

National Domestic Violence Hotline: 800-799-7233 

RAINN: Rape, Abuse and Incest National Network: 800-656-4673

Trans Lifeline877-565-8860

Privacy Practices

The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.

 

Exceptions include:

 ​

  • If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.

  • If a client intends to harm themselves, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.

  • Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.

             Good Faith Estimate

A Good Faith Estimate will be provided in the initial session for clients who, as dictated by the current law, are paying out of pocket without using insurance benefits. This estimate shows the costs of items and services that are reasonably expected for your 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 could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.


If you are billed for more than the 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 Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance 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 4 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 with you, you will have to pay the price on 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.


For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises. Keep a copy of the Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.


 
bottom of page