(For self pay/out of network clients)

You have the right to receive a GFE explaining how much your medical and mental health care will cost.

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals need to give clients who either do not have insurance or who are not using insurance a GFE of expected charges for medical services, including psychotherapy.

• You have the right to receive a 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.

• You can ask your health care provider, and any other provider you choose, for a GFE before you schedule a service. However, you must receive a GFE in writing at least 1 business day before your scheduled medical service or item when scheduled three days in advance and at least 3 business days prior to your appointment when scheduled 10 days in advance.

What you will receive in your GFE:

You will receive a written GFE that includes an estimate of services (type of therapy/estimate of frequency) and estimated costs for those services for a 12 month period.  

Psychotherapy is unique in that it is not possible to predict how your personal therapeutic process will unfold until we get started; there are many factors that contribute to this and every person’s plan is different. The following is information that will help you anticipate and plan the cost of your therapy with Katie Wangelin, MSW, LCSW:

At times, additional services are requested/required, for example in times of stress or emergency, high conflict scheduling issues, collaboration with other professionals, or collaboration with other family members (for example in the case where a minor is the client there will be additional sessions with parents ranging from weekly to monthly depending on the minor’s age and therapeutic needs).  All other fees will be noted in the Fee Policy prior to intake.

You have the right to dispute your charges if: 

• If you receive a bill that is at least $400 more than your GFE, you can dispute the bill.

• Make sure to save a copy or picture of your GFE.

For questions or more information about your right to a GFE, visit www.cms.gov/nosurprises or call (800) 368-1019.