At Mindfulness Matters Behavioral Health, LLC, we are committed to providing transparency regarding the cost of mental health services.

Under the No Surprises Act, individuals who are uninsured, self-pay, or choose not to submit claims through their insurance plan have the right to receive a Good Faith Estimate explaining the expected costs of their care before services begin.

A Good Faith Estimate provides an overview of the anticipated charges for mental health services based on the information available at the time the estimate is created. This estimate may include services such as:

• Initial diagnostic assessments
• Individual psychotherapy sessions
• Play therapy
• Family therapy
• Parent consultations
• Other clinically appropriate services

A Good Faith Estimate is provided to help you understand your potential financial responsibility. It is not a contract and does not require you to receive services.

The actual cost of treatment may vary depending on your individual needs, treatment goals, frequency of sessions, and any additional services that may become clinically appropriate.

If your care needs change significantly, an updated estimate may be provided.

You may request a Good Faith Estimate before beginning services or at any time during treatment if you are paying out-of-pocket.

To request an estimate or ask questions about fees and payment options, please contact:

Kambra Deitz, MSW, LICSW-PIP, RPT-S
Mindfulness Matters Behavioral Health, LLC

If you receive a bill that is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.

For more information about your rights under the No Surprises Act, visit:

www.cms.gov/nosurprises

or call:

1-800-985-3059

Mindfulness Matters Behavioral Health, LLC is dedicated to providing compassionate, accessible mental health care while maintaining transparency and clarity regarding costs and financial expectations.