Your Right to a Good Faith Estimate
Under the federal No Surprises Act.
You have the right to receive a Good Faith Estimate explaining how much your medical and mental health care will cost.
Under the law, health care providers must give patients who don't have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including psychotherapy.
- You can ask your 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 www.cms.gov/nosurprises or call 1-800-985-3059.
Notice of Privacy Practices (HIPAA)
Powers of Mind Psychological Services is committed to protecting the privacy of your health information. Our Notice of Privacy Practices describes how medical and mental health information about you may be used and disclosed, and how you can get access to this information, in accordance with the Health Insurance Portability and Accountability Act (HIPAA).
You have the right to receive a copy of our full Notice of Privacy Practices. To request one, please contact us at 850-807-9801 or info@drpowerstherapy.com. This website is for general information and is not intended for the transmission of protected health information; please do not share sensitive health details through website forms, text, or email.
Nondiscrimination and Accessibility
Powers of Mind Psychological Services complies with applicable civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. We are committed to providing a welcoming, respectful environment for every client.
If you need assistance, a reasonable accommodation, or language assistance to access our services, please contact us at 850-807-9801 and we will do our best to help.
Contact
Powers of Mind Psychological Services
901 N. Gadsden Street, Tallahassee, FL
Phone/Text: 850-807-9801
Email: info@drpowerstherapy.com
This page is provided as a general template for informational purposes and does not constitute legal advice. Federal and state notice requirements change; please confirm the current requirements and exact required language with a qualified attorney or compliance professional and provide individualized Good Faith Estimates and your full Notice of Privacy Practices as required.