Good Faith Estimate

Your Right to Understand the Expected Cost of Counseling
Under the federal No Surprises Act, individuals who do not have health insurance or who choose not to use their insurance to pay for healthcare services generally have the right to receive a Good Faith Estimate of expected charges.
A Good Faith Estimate is not a bill or a contract. It provides an estimate of the anticipated costs of care based on the information available at the time it is prepared.
Ivory Oak Counseling & Wellness is launching in 2027. Counseling services are not yet available. The information below describes the estimate process that will apply when scheduling begins.

Planned Counseling Fees
Our anticipated private-pay fees are:
ServiceDurationFeeInitial Diagnostic Assessment60 minutes$120Individual Counseling Session50 minutes$100
Fees are subject to change before the practice opens. Current fees will be confirmed before services begin.
A personalized Good Faith Estimate will describe expected charges based on your anticipated services, session frequency, and treatment arrangements.

When You Can Receive an Estimate
When services become available:
If you schedule at least 3–9 business days in advance, you generally must receive your estimate within 1 business day after scheduling.
If you schedule at least 10 business days in advance, you generally must receive your estimate within 3 business days after scheduling.
If you request an estimate without scheduling an appointment, you generally must receive it within 3 business days after the request.
Estimates will be provided in writing as required by applicable law.

What Your Estimate May Include
An individualized estimate may identify:
The type of counseling services expected
The anticipated number or frequency of sessions
The estimated duration or period of care
The cost of each service
The anticipated total charges
Applicable service codes, diagnostic information, and other information required by law
The actual duration of counseling varies. If the anticipated services or expected charges change, an updated estimate may be provided when required.

If Your Bill Exceeds Your Estimate
If a provider's bill is at least $400 more than the Good Faith Estimate from that provider, you may qualify to dispute the bill through the federal patient-provider dispute resolution process.
Generally, the dispute must be initiated within 120 calendar days after receiving the initial bill.
Keep a copy of your Good Faith Estimate for your records.
For more information about your rights, visit:
https://www.cms.gov/medical-bill-rights
You may also contact the No Surprises Help Desk at 1-800-985-3059.

Requesting a Good Faith Estimate
Once counseling services are available, you may request an estimate or ask questions about anticipated fees by contacting:
Ivory Oak Counseling & Wellness
Email: info@ivoryoakcounseling.com
Phone: (832) 510-7866
Do not include detailed clinical information in a general website inquiry.
Receiving a Good Faith Estimate does not obligate you to begin or continue treatment. Additional practice policies, including any cancellation or missed-appointment fees, will be disclosed before services begin.