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Green Suede

Legal Disclaimers for Clients

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.

Under the law, health care organizations need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. 

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.  This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care organization gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care organization, and any other organization you choose, for a Good Faith Estimate before you schedule an item or 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.

INFORMATION REGARDING CONSUMER ACCESS TO HEALTH RECORDS AND COMPLAINTS.

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  • Record Access: You are entitled to access to your healthcare records as a client. To access your records, please submit a request with your clinician either verbally or in writing. Your records will then be supplied within the legally required window.

  • Official Complaints to Licensing Board: While clients are encouraged to discuss concerns with me directly to foster a desired resolution, you may file a complaint against me with the organization below should you feel I am in violation of the following code of ethics. I abide by the ACA Code of Ethics.

    • Texas State Board of Examiners of Professional Counselors

      • 333 Guadalupe St, Tower 3, Room 900, Austin, Texas 78701

      • Main phone: (512) 305-7700

      • Complaint Line: 800-821-3205 (24-hour, toll-free complaint system)

  • Consumer Complaints: To file a consumer complaint as a client of this therapy practice, you may file such a complaint with the TX Attorney General's office here.

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