No Surprises Act, 2022
STANDARD NOTICE
“Right to Receive a Good Faith Estimate of Expected Charges”
Under the NoSurprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to provide patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and 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 one 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.
- 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 Dr. Joan Hall at 256-975-7865.
Download a copy of this notice.
Therapy Fee Structure (for private pay without insurance):
- Individual therapy – $160 per hour
- Group therapy – $60 per 90 minutes
- No Show/Late Cancellation fee – $160
Insurance Billing
Our insurance credentialing is in progress; check back periodically for more information on insurance plans accepted.
- Blue Cross Blue Shield of GA (HMO and PPO)
- Blue Cross Blue Shield of New Jersey
- Anthem Blue Cross Blue Shield
- Aetna
- Blue Cross Blue Shield of Massachusetts
- Cigna
- Oscar Health
- Oxford
-
United Health Care and Optum
Payments
Personal checks are not accepted.
All payments are made online through a secure network using HIPAA-compliant electronic health record platform.