ONLINE THERAPY IN ARIZONA, COLORADO & MINNESOTA
Laura Carrillo, LPC
Good Faith Estimate Notice
Your Right to Receive a Good Faith Estimate
Under federal law, health care providers are required to provide patients who do not have insurance, are not using insurance benefits, or are self-paying for services with a Good Faith Estimate of expected charges for health care services.
You have the right to receive a Good Faith Estimate explaining the anticipated cost of services before you receive care.
A Good Faith Estimate will include reasonably expected charges for psychotherapy services and any other services that may be provided in connection with your care.
The Good Faith Estimate is based on information known at the time it is provided and does not constitute a contract or guarantee of the total cost of services. Actual charges may vary depending on your clinical needs, treatment goals, frequency of appointments, cancellations, missed appointments, additional services requested, changes in fees, or other factors.
You may request a Good Faith Estimate at any time before scheduling a service or during the course of treatment. A Good Faith Estimate will be provided in accordance with applicable federal and state laws.
If you receive a bill that is substantially higher than your Good Faith Estimate, you may have the right to dispute the charges through the federal patient-provider dispute resolution process.
For questions about your Good Faith Estimate or fees for services, please contact:
First Step Therapy LLC
480.741.8686
laura.carrillo@firststeptherapyaz.com
For more information about your rights under the No Surprises Act, visit the official federal website at:
https://www.cms.gov/nosurprises?
Additional Website Fee Disclaimer
Fees listed on this website are provided for informational purposes only and are subject to change. Posted fees do not constitute a Good Faith Estimate. Individual treatment plans, service frequency, and total costs may vary. A personalized Good Faith Estimate is available upon request and will be provided when required by applicable law.