Good Faith Estimates

What is surprise/balance billing? 

When you see a counselor or other health care provider out-of-network or not using any healthcare insurance, you will pay for these services “out-of-pocket” or “private pay,” meaning the costs are billed directly to you.  

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is
involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical
bills could cost thousands of dollars depending on the procedure or service.

Good Faith Estimates (GFE) for MBHS 

This is a summary of expected expenses associated with the expected psychotherapy services while under treatment at McMillan Behavioral Health and Addition Services (MBHS), because MBHS is unable to process insurance or no insurance.  

Here are common psychotherapy CPT codes used at MBHS:  

90871 – Psychiatric Diagnostic Evaluation  
90837 – Psychotherapy, 60 minutes  
90834 – Psychotherapy, 45 minutes  
90853 – Group Therapy  
90785 – Interactive Complexity Add-on (additional psychotherapy time beyond 60 minutes) 

Initially, most clients will be billed for an intake (Psychiatric Diagnostic Evaluation), at the agreed upon fee, prior to the appointment.  

Each subsequent appointment will be assessed a fee based on the agreed upon fee for each type of appointment, dependent on treatment goals established.
 

Disclaimer:  

• There may be additional items or services that are recommended as part of the treatment that will be scheduled separately and are not reflected in the good faith estimate, dependent on the course of psychotherapy treatment as determined by the counselor named above.
• That the information provided in this Good Faith Estimate is only an estimate and that actual items, services, or charges may differ from the actual services provided; if the services differ, you will be notified prior to incurring any fees.
• That this Good Faith Estimate does not require you, the client, to obtain psychotherapy or other services from MBHS. This is not a binding contract.

 
For further information or questions please contact Mark McMillan, owner at Mark@Mark-McMillan.com.