Good Faith Estimate

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate 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.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. 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.

The following are the standard fees for services provided by Anne Rose, LMFT:

These fees represent the cost per session. The total cost of your care will depend on the number of sessions recommended, which varies based on your individual needs and treatment goals.

A limited number of sliding scale fee slots are available for clients who demonstrate financial need. Please contact Anne directly to discuss sliding scale options.

Anne Rose, LMFT is an out-of-network provider and does not bill insurance directly. Upon request, a superbill (itemized receipt) can be provided for you to submit to your insurance company for potential out-of-network reimbursement. Please contact your insurance provider to understand your out-of-network mental health benefits.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

To request a personalized Good Faith Estimate or if you have questions about your expected costs, please contact: