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REQUIRED INFORMATION

NOTICE OF PRIVACY PRACTICES

When it comes to your health information, you have certain rights. Our Notice of Privacy Practices describes how information about you may be used and disclosed, and how you can get access to this information. Click here to download our Notice of Privacy Practices.

GOOD FAITH ESTIMATE
Good Fait Estimate

Starting from January 1, 2022, healthcare providers are obligated by law to furnish uninsured and self-pay patients (including cash pay and private pay) with a good faith estimate of the anticipated costs for the services they provide. Emphasizing our commitment to transparent billing practices, we present a straightforward calculation method as part of the Good Faith Estimate. ALCAS's psychotherapy services operate on a private pay basis, with a specified rate for each session provided. Simply multiply the applicable rate by the anticipated number of sessions per week, month, or year to determine your Good Faith Estimate.

For instance, if you have sessions with Katie every other week at a rate of $150 per session, your Good Faith Estimate would be $150 every other week, $300.00 per month. So hypothetically if you were to have two sessions a month for a year then ( 300.00 X 12 months) your fee would be  $3600. Compliant with the "No Surprises Act," we are more than willing to furnish a written Good Faith Estimate upon request. Please also note this estimate is not a contract and does not obligate you to obtain any therapy services from the provider listed, 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 concerning your treatment and may discontinue treatment at any time. While it is not possible for a psychotherapist to know specifically, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, this estimate provides a general 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. Please note your treatment is based on a fee-per-service model, which means you pay at the time of service rendered. Therefore, no bills or accrued bills or usually provided. However,  the Good Faith Estimate aims to prevent clients from receiving bills they were not expecting, aka “No Surprises.” A Good Faith Estimate is for your awareness only and does not require immediate financial commitment or payment.

PLEASE NOTE: Assessment services are subject to a distinct and different fee structure, and the associated charges for the evaluation will be discussed prior to the appointment scheduling. A comprehensive overview of the service fees, accompanied by a formal fee agreement (fee for service contract), will be included in the initial documentation sent to you prior to the evaluation process. However, your agreement will be obtained before services can be rendered for an evaluation. Please note additional documentation you request beyond your evaluation fee (see new fee policy for additional support documentation) may be subject to additional fees or charges, which you will be notified upon your request. 

NOTICE CONCERNING COMPLAINTS

The Texas Behavioral Health Executive Council investigates and prosecutes professional misconduct by marriage and family therapists, professional counselors, psychologists, psychological associates, social workers, and licensed specialists in school psychology. Although not every complaint against or dispute with a licensee involves professional misconduct, the Executive Council will provide you with information about how to file a complaint. Please call (800) 821-3205 or visit the Texas Behavioral Health Executive Council for more information.

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