An individual's GFE is dependent upon the frequency of their appointments as well as the expected duration of treatment and may be adjusted as either of these factors change
A written GFE is provided at the start of treatment for each individual who is not accessing their in-network insurance benefits.
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 1 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 800-985-3059.
All patients seeking Mental Health Services at Birch & Pine Counseling are assured that they will be served regardless of ability to pay. No one is refused service because of lack of financial means to pay. This program is designed to provide free or discounted care to those who have no means, or limited means, to pay for their services (uninsured or underinsured).
Birch & Pine Counseling will base program eligibility to a person's ability to pay and will not discriminate on the basis of an individual's race, color, sex, national origin, disability, religion, age, sexual orientation or gender identity. The Federal Poverty Guidelines are used in creating and annually updating the sliding fee schedule to determine eligibility.
The patient/ responsible party must complete in its entirety, the sliding fee discount program application located at the front desk. Staff will available, as needed, to assist patient/ responsible party with applications. By signing the sliding fee discount program application, you are confirming your income to Birch & Pine Counseling as disclosed on the application form.