Good Faith Estimate notice for Shelby Castile, LMFT
Effective Date: January 1, 2025
Under the No Surprises Act, health care providers are required to provide clients with a Good Faith Estimate of expected charges for services.
1. Your Right to a Good Faith Estimate
You have the right to receive a Good Faith Estimate explaining the expected cost of your mental health care services.
This estimate is provided for individuals who are:
Not using insurance
Choosing to self-pay for services
2. What the Estimate Includes
The Good Faith Estimate outlines:
The cost per session
The anticipated number of sessions (if known)
Any additional fees related to services
For Shelby Castile, LMFT:
50-minute session: $275
Additional services (coaching, consultation, extended sessions) may vary and will be discussed in advance
3. Important Considerations
The Good Faith Estimate is not a contract and does not obligate you to receive services.
Actual costs may vary depending on your individual needs and treatment plan.
You will be informed of any changes to fees in advance.
4. Disputes
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
You may contact:
U.S. Department of Health and Human Services (HHS)
For more information: www.cms.gov/nosurprises
5. Requesting an Estimate
You may request a Good Faith Estimate at any time before scheduling services or during the course of treatment.
6. Contact Information
If you have any questions regarding your estimate or fees, please contact:
📲 Phone: 949.436.7347
📧 Email: shelby@shelbycastile.com
📩 Mailing Address: 1151 Dove Street Suite 105, Newport Beach, CA 92660
Thank you for visiting Shelby Castile, Shelby Castile, LMFT