Grounded Healing for Mind, Body, and Relationships
You understand the "why" behind your struggles, but your nervous system hasn’t caught up yet. I offer integrative psychotherapy that goes beyond talk therapy, combining Internal Family Systems (IFS), somatic processing, and outdoor ecotherapy to help you feel settled, connected, and whole.
Good Faith Estimate (No Surprises Act) Notice
Under the federal No Surprises Act, 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.
Your Right to a Good Faith Estimate
You have the right to receive a Good Faith Estimate (GFE) 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. For our practice, this primarily applies to your expected charges for psychotherapy sessions, therapy intensives, clinical consultations, or group cohorts (such as the Healers KAP Group).
How to Request or Receive Your Estimate:
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Make sure your health care provider gives you a Good Faith Estimate in writing at least one (1) business day before your medical service or item.
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You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
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Upon scheduling a session or an intake, our practice will provide you with a customized Good Faith Estimate document via your secure SimplePractice Client Portal to review and sign prior to your appointment.
What the Estimate Includes:
The Good Faith 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.
Please note: 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.
Disputing a Bill:
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
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You may contact the health care provider or facility listed 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.
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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.
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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 or call 800-985-3059.
Make sure to save a copy or picture of your Good Faith Estimate.
Contact Us
If you have questions regarding our fees, billing practices, or your specific Good Faith Estimate, please reach out to us at: Email: info@musenge.com Phone: (615) 488-8011