Good Faith Estimate
Effective January 1, 2022 under Section 2799B-6 of the Public Health Service Act, a ruling went into effect called the "No Surprises Act" which requires practitioners to provide a "Good Faith Estimate" about out-of-network care. The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for treatment. The estimate is based on information known at the time the estimate was created.
Services will be rendered at 10149 N 92nd Street, Suite 103, Scottsdale, AZ, 85258.
NPI: 1427910272
Taxonomy Code: 106H00000X
Common Therapy Services codes provided at All Kinds of Love Therapy:
90791: Initial therapy Intake
90834: 44 to 50-minute individual psychotherapy session
90837: 75- or 90-minute individual psychotherapy session
90847: Family/Couples psychotherapy session
Z63.0: Problems in relationship with spouse or partner
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. Furthermore, it requires an initial diagnosis indicating the reason for therapy. This diagnosis is only to satisfy the federal requirement for this form, it is not considered a formal psychological diagnosis. As out-of-network providers working from a humanistic model, we typically do not diagnose clients in our care. It is within your rights to decline a diagnosis by state and federal guidelines. Any change or addition of diagnosis/diagnoses upon completion of Assessment will not affect Good Faith Estimates in the delivery of Psychotherapy.
A note about diagnosis:
At All Kinds of Love Therapy, we do not typically diagnose clients unless we believe a special diagnosis to be accurate after we have had time to assess and evaluate. Instead of diagnostic codes we typically use Z codes which represent general areas of concern to be discussed in therapy. Please speak to your therapist about this if you have more questions.
For purposes of this Good Faith Estimate, your initial diagnosis will be Diagnosis Code Z04.9, Encounter for Examination and Observation for Unspecified Reason.
Dr Lea Barber’s current rate: $200/50 minutes
To estimate your cost for 12 months, multiply the number of sessions you plan to attend by your therapists' full fee.
**Cancellation Fee: if you need to cancel your appointment, you must call 24 hours in advance or you will be charged the full session fee.
**Legal Fees: testimony-related matters including but not limited to case research, report writing, travel, depositions, actual testimony, phone consultations, documentation preparation, cross-examination time, and courtroom waiting time will be billed at $450/hour, portal-to-portal in 15-minute increments and will be paid prior to time of service or shortly thereafter.
Common Factors that may affect Good Faith Estimates:
We recognize that 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:
1. Your schedule and life circumstances
2. Therapist and client availability
3. Ongoing life challenges
4. The nature of your specific challenges and how you address them
5. Whether you experience any kind of crisis that may necessitate increasing frequency or adding in other types or modalities of therapy; such as individual, couple, or family counseling.
You and your therapist 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, or if an increase in services is needed.
Disclaimer:
You are entitled to receive this "Good Faith Estimate" of what the charges could be for psychotherapy services provided to you. While it is not possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy 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 All Kinds of Love Therapy, 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 psychotherapy 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 any recommendations made to you concerning your treatment and you may discontinue treatment at any time.
This Good Faith Estimate shows the costs of the services that are reasonably expected for your health care needs. The estimate is based on the information known at the time the estimate was created. This 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 or appeal the bill.
This Good Faith Estimate is not a contract and therefore does not require you to obtain the times or services provided by All Kinds of Love Therapy. At the foundation of a good therapeutic relationship between client and therapist is the client’s right to autonomy and self-determination. Therefore, you have the right to terminate services at any time.
If you are billed for more than this Good Faith Estimate, you have a right to dispute the bill.
You may contact the health care provider at All Kinds of Love Therapy 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.
You may also start a dispute resolution process with the US 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 (4 months) of the date of 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 the 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 https://www.cms.gov/nosurprises or call 1-800-985-3059