Disclaimer for Good Faith Estimate for Cash Pay and Out of Network Patients:

Effective January 1, 2022, Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” (GFE) of expected charges. The GFE shows the costs of items and services that are reasonably expected for services provided. The estimate is based on information known at the time the estimate was created. It does not take into account any reimbursement that you may receive as a result of out of network benefits.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.

You may contact Tandra to let her know the billed charges are higher than the Good Faith Estimate. You can ask her to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

In general fee's for individual therapy are $200 per session and can range in frequency from weekly to quarterly depending upon your specific needs and goals. Support groups and classes range from $25 -$80 each meeting depending on the type of group agreed to.

Tandra will discuss with you during your initia l meeting, the fees associated with the expected services and answer questions that you may have.

Estimation of Costs for In Network Patients

If it is determined that you will be utilizing network benefits with your insurance, it is your responsibility to obtain information regarding expected co pays or co insurances from your insurance company. These are estimates based upon information provided by your insurance company and may not be accurate. Because they are contracted rates, deductible, co-pays, and co-insurances are non-negotiable.

Insurance:

Tandra is a provider for many health insurance companies including and not limited to:

• Avera
• BCBS
• Health Partners
• UBH
• UMR
• United Health Care
• Sanford

If you do not see your health insurance carrier listed please contact me as this list may not be updated