Good Faith Estimate
Good Faith Estimate
Effective Date: April 1, 2026
Your Rights Under the No Surprises Act
At KNI Therapy LLC, we believe that financial transparency is a cornerstone of an ethical therapeutic relationship. In accordance with the No Surprises Act (H.R. 133), you have the right to receive a Good Faith Estimate (GFE) explaining the expected cost of your mental health care if you are uninsured or choosing not to use insurance for your sessions.
This estimate provides a projection of service fees based on the information available at the time of the request, allowing you to make fully informed decisions about your treatment.
1. What is a Good Faith Estimate?
A GFE outlines the anticipated costs for therapy sessions or related services reasonably expected for your care.
Scope: The estimate is an informed projection; it may not include unexpected costs that could arise due to changes in your clinical needs or treatment plan.
Non-Binding: A GFE is not a contract. It does not require you to proceed with services, nor does it limit your right to seek care elsewhere.
Accessibility: You may request an estimate at any time, even if you have not yet scheduled an appointment.
2. Out-of-Network & Billing Practices
If you choose a provider outside of your insurance network, you may be responsible for higher out-of-pocket costs.
No Balance Billing: "Balance billing" occurs when a provider bills you for the difference between their fee and what your insurance covers. KNI Therapy LLC does not engage in balance billing.
Out-of-Pocket Costs: If you are paying privately, the total cost per session will be clearly outlined in your Good Faith Estimate and will not exceed our standard fee schedule without prior notification.
3. The Right to Dispute
If you receive a bill that is at least $400 more than the amount listed on your Good Faith Estimate, you have the legal right to dispute the charges.
Our Process: We encourage you to contact us directly to review the bill or discuss a payment plan.
Federal Dispute Resolution: You may initiate a formal dispute through the U.S. Department of Health & Human Services (HHS). This process must be started within 120 days of the date on the bill. Note that there is a federal administrative fee (currently $25) for this process.
4. Delivery Timeline
We will provide your Good Faith Estimate within the following windows:
Scheduled 10+ days out: Within 3 business days of scheduling.
Scheduled 3–9 days out: Within 1 business day of scheduling.
Upon Request (No appointment scheduled): Within 3 business days of your request.
Commitment to Clarity
We are dedicated to ensuring you never feel caught off guard by the cost of your care. If your treatment plan changes significantly, we will issue an updated Good Faith Estimate to reflect those adjustments.
Questions or Requests? Please contact us at katelyn@kni-therapy.com to request an estimate or for any questions regarding your billing.
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