Billing
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Blue Cross Blue Shield
Sanford Health Plan
North Dakota Medicaid
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If you have out-of-network insurance coverage I can provide you with a super-bill, which is a medical receipt, that can be submitted to your insurance company for possible reimbursement.
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Intake: $230
60 Minute Session: $200
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This $25 add on charge is used billing session when use of play equipment, sand tray, physical devices including art interventions, worksheets, and/or workbooks is utilized to assist in the communication and reflection of patient. Insurance coverage of this code is dependent upon your individual plan coverage and can be discussed further with provider.
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As of January 1, 2022, all healthcare providers are required to provide estimates for the costs of your care. The Good Faith Estimate shows the costs of items and/or services that are reasonably expected for your healthcare needs and treatment. This will be provided by this office upon scheduling and/or as requested. The Good Faith Estimate does not include unexpected costs that could arise during treatment.
Under the No Surprises Act (H.R. 133, in effect as of January 1, 2022), health care providers need to give clients or patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.
This 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.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes (under the law/when applicable) related costs like medical tests, prescription drugs, equipment, and hospital fees.
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 receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
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.
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 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.
Make sure your health care provider gives you a Good Faith Estimate within the following timeframes:
If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;
If the service is scheduled at least 10 business days before the appointment date, no later than three business days after the date of scheduling; or
If the uninsured or self-pay patient requests a good faith estimate (without scheduling the service), no later than three business days after the date of the request. A new good faith estimate must be provided, within the specified timeframes if the patient reschedules the requested item or service.
Note: A Good Faith Estimate is for your awareness only. It does not involve you needing to make any type of commitment.
To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call (800)-985-3059.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059.
Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You will need it if you would want to dispute a bill. Please contact us with any questions or concerns.t goes here
Cancellation Policy
Text reminders can be provided to support attendance of appointments, but it is ultimately the responsibility of the client to attend sessions or provide a 24hr cancellation notice. If client does not attend appointment and did not provide proper notice, a $75 fee will be charged. This fee is not covered by insurance and will be required to be paid before further appointments can be scheduled.
I do understand that life happens, and advanced notice may not always be possible. These situations will be evaluated on a case-by-case basis. Client must contact provider through call, text, or email to have this discussed further. If no shows or late cancellations become a habit the services may be terminated.
