Do you take insurance?

Heart to Heart Counseling & Coaching does not accept insurance at this time, but will provide a monthly invoice that can be submitted to the client’s health care providers for reimbursement.

Duration, Fees & Payment

The fee for weekly sessions is $250 for individuals (60-minute session) and $275 for couples (60-minute session). The fees are due at the start of each session. An objective measure form will be provided to determine your progress and evaluation. Please contact me directly for further details. Some clients may benefit from more support and arrangements can be made to accommodate this need.

What is the cancellation policy?

Heart to Heart Counseling & Coaching has a 24-hour cancellation policy. Failure to provide adequate notice will result in a charge for the full session and that amount will not be able to be listed on any requested superbills as insurance companies do not cover missed appointments.

Termination of Therapy

The length of treatment and the timing of the eventual termination of treatment depend on the specifics of your treatment plan and the progress you achieve. Ideally, we will collaborate to determine when the conclusion of our work together is appropriate and plan accordingly. You may discontinue therapy at any time.

Heart to Heart Counseling & Coaching/Cynthia Dennis reserves the right to terminate therapy if:

• Fees are not paid on time

• You are not (or are no longer) benefiting from treatment

• There is a failure to comply with recommendations or to participate in therapy

• Any conflict(s) of interest are identified

• Your needs are outside of the practice’s scope of competence and we will attempt to provide you with appropriate referrals

What is a good faith estimate?

No Surprises Act

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE

MEDICAL BILLS

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

• Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable  condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

• Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections  not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

• Your health plan generally must:

  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).

  • Cover emergency services by out-of-network providers.

  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact: The California Department of Insurance.

See Model Disclosure Notice Regarding Patient Protections Against Surprise Billing Instructions for Providers and Facilities for more information about your rights under Federal law.

Schedule your free 20-minute phone consultation today!