New Client Paperwork
Authorization of Disclosure
Good Faith Estimate Notice
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. This applies to music therapy services provided by Asheville Psychotherapy Services, PLLC.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy and music therapy services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy and music therapy services.
You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a 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: http://www.cms.gov/nosurprises
EMDR or Verbal Processing Session @ 55 minutes = $125
GIM Session @ 85 minutes = $175
While I do not accept health insurance, I am able to accept H.S.A. card payments. Please verify H.S.A. coverage with your current provider. Payment is expected on the day of our meeting. All forms of payment are accepted including credit card, check or cash.