Garden of Yes

Kristina m. scott, AMFT, sep, SSHP

at Axis Mundi Center for mental health

Registered Associate Marriage & Family Therapist, #125384

Supervised by Gieve Patel, LMFT #47196

Providing sex therapy and couples therapy for adults in California, including San Francisco, Oakland, San Jose, & beyond

GOOD FAITH ESTIMATE

The No Surprises Act, a federal law effective from January 1, 2022, grants you the entitlement to a "Good Faith Estimate," elucidating the anticipated costs of your medical and mental health care. This law mandates healthcare providers to furnish uninsured patients or those not utilizing insurance with an estimate of expected charges for medical services, including psychotherapy.

You possess the right to request a Good Faith Estimate detailing the projected total cost of any non-emergency healthcare services, including psychotherapy, from your healthcare provider or any alternative provider before scheduling a service.

Should you receive a bill surpassing your Good Faith Estimate by at least $400, you have the right to dispute the bill. It is advisable to retain a copy or image of your Good Faith Estimate. For additional information or inquiries about your entitlement to a Good Faith Estimate, you can visit www.cms.gov/nosurprises.

The estimate provided covers the cost of services until the conclusion of the calendar year in which you commence therapy. It's important to note that a Good Faith Estimate does not constitute a contract, a treatment recommendation, or a prediction regarding the necessity for a specific number of psychotherapy visits. The appropriateness of the number of visits and their estimated cost depends on your individual needs and agreements made in consultation with your therapist.

Feel free to discuss queries about your collaborative treatment plan or the information provided in the Good Faith Estimate with me anytime. You retain the option to discontinue treatment at any point. A new Good Faith Estimate will be provided at the commencement of each new calendar year, covering a maximum period of 12 months.