Nicole Nemiroff, MA LMFT
Holistic Therapy Services
NOTICE TO CONSUMERS OF PSYCHOLOGICAL SERVICES
The Department of Consumer Affairs’ Board of Psychology receives and responds to questions and complaints regarding the practice of psychology. If you have questions or complaints you may contact the Board on the Internet at http://www.psychology.ca.gov, calling 1-866-503-3221, or writing to the following address:
Board of Psychology
1625 North Market Blvd. Suite N-215
Sacramento, CA 95834
EXPECTATIONS FOR BILLING
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.
As an out-of-network provider, I receive payment directly from clients for services that we engage in and do not directly bill any insurance providers. If clients wish to use their insurance benefits, I will provide a monthly “Superbill” at no additional cost. Such a document contains basic information regarding the frequency and types of services rendered, and allows the client to submit a claim for reimbursement to their insurance company if their plan covers out-of-network psychotherapy services, or to utilize tax-free health savings account (HSA) funds.
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 healthcare services, including psychotherapy services.
You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
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