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, by emailing email@example.com, calling (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
If you are not using Lyra benefits, therapy would be considered out-of-network. As an out-of-network provider, I receive payment directly from clients for services that we engage in and do not directly bill insurance companies. If a client wishes to use their individual insurance benefits, I will provide a monthly “superbill” at no additional cost. A superbill 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.
Additionally, pursuant to the requirements of H.R. 133 (the “No Surprises Act”), as of January 1, 2022, clients have the right to receive a “Good Faith Estimate” of total costs for non-emergency out-of-network services prior to engaging in any billable treatment. The good faith estimate shows the cost of services that are reasonably expected to occur, based on the information known at the time the estimate is prepared.
- The good faith estimate will include all anticipated recurring services and costs for up to a 12-month period (or less if briefer treatment is planned).
- The good faith estimate will be updated both orally and in writing no less than once per 12-month period or whenever the anticipated cost of services changes.
- The good faith estimate will be made available by the provider to the client at least 1 business day before any billable services are planned.
- If the client receives a bill that is more than the good faith estimate they have the right to dispute that bill with the U.S. Department of Health and Human Services. Such a process must be initiated no more than 120 days from the date of the bill being disputed.
Additional information can be found at: http://www.cms.gov/nosurprises