Since the start of the COVID-19 pandemic, our environments have been in flux in many challenging ways. Our daily routines, plans for the future, interpersonal relationships, and sense of self have all been destabilized. I am available to help ground you during this time, providing confidential therapeutic sessions from the privacy of your own home. I specialize in treating anxiety and depression, particularly in response to traumatic experiences. I offer individual psychotherapy sessions, as well as yoga and dance instruction. I also provide live counseling sessions through BetterHelp. Click here to read testimonials from clients I’ve worked with on that platform. Wellness is dynamic, and I would be honored to help you move forward. To book a session or for more information, click here or fill out the form below:
New federal regulations implementing the No Surprises Act (enacted by Congress in 2020) went into effect on January 1, 2022. The aim of the law is to protect consumers from unanticipated medical bills. There are three (3) parts to the regulations that were developed by multiple federal agencies including the US Department of Health and Human Services (HHS).
Part II requires all health care providers, including clinical social workers (CSWs) and health care facilities licensed, certified or approved by the state to provide good faith estimates (GFEs) of expected charges for services and items offered to uninsured (e.g., not enrolled in any health plan) and self-pay (e.g., not planning to file a claim with their plan) consumers. Effective January 1, 2022, any health care provider or health care facility subject to state licensure must provide a GFE of expected charges for services and items within specific timeframes to current/established and future patients. These new regulations set forth specific requirements for how providers need to inform patients of their right to a GFE, what these good faith estimates must contain and how records are to be maintained. Part II of the regulations also establishes a process for consumers to dispute provider charges that “substantially exceed” a good faith estimate. (“Substantial” is defined as $400 or more). GFEs do not need to be provided to patients who are enrolled in federal health insurance plans (e.g., Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system).
Providing a GFE to patients is not new to CSWs who, as part of best clinical and ethical practice, routinely discuss services and fees before or during the initial interview with new patients and provide informed consent forms. However, the new federal rule formalizes this process and it is now a matter of federal regulatory compliance.
“No Surprises Act” requires practitioners to provide a “Good Faith Estimate” to individuals who are uninsured or utilize self-pay. The Good Faith Estimate (referred to throughout this document as “GFE”) works to show the cost of items and services that are reasonably expected for your health care needs for service, a diagnosis, and a reason for mental health services. The estimate is based on information known at the time the estimate was created. The GFE does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new GFE should this occur. If this happens, federal law allows you to dispute (appeal) the bill if you and your provider have not previously talked about the change and you have not been given an updated GFE.
Clinical social workers have always shown the exact costs of services before payment, as our licensing boards require fees to be included in Informed Consent. At or before the time of your first appointment, you will complete a fee agreement with your therapist. Any changes to fees will require a new fee agreement to be signed before the changes takes effect. As the purpose of the bill is to prevent surprise out of pocket costs, we are not the intended use case for this legislation.
The Clinical Social Work Association is working on two fronts to get LCSWs exempted from the GFE. One is a letter co-written with the Psychotherapy Action Network. The other is a campaign to let members of Congress know about the fact that LCSWs in private practice do not need to be part of the GFE; we already do everything that it requires and there are vanishingly low numbers of LCSWs who have had actionable complaints filed against them for surprise billing.
At this time, Renée Gaubert, LCSW is complying with this federal regulation by providing all clients with GFEs as per the current requirements discussed above.
Billing Codes & Fees
I use an electronic health record (EHR) that uses the Current Procedural Terminology (CPT) codes that the GFE requires.
Individualized Treatment
Every individual’s therapy journey is unique and personalized. How long you need to engage in mental health services and how often you attend sessions will be influenced by many factors, including, but not limited to:
Your schedule and life circumstances
Your therapist’s availability
Ongoing life challenges
The nature of your specific challenges and how you address them
Personal finances
You and your therapist will continually assess the appropriate frequency of services and will work together to determine when you have met your goals and are ready for discharge, or to adjust your treatment plan if your goals change. You can also choose to stop therapy at any time. For these reasons, your GFE may include the cost of a single session up to 104 sessions per year.
Good Faith Estimate Disclaimer
As a client of Renée Gaubert, LCSW, you are entitled to receive a Good Faith Estimate of what the charges could be for clinical social work/psychotherapy services provided to you. While it is not possible for a clinical social worker to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you.
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service.
This estimate is not a contract and does not obligate you to obtain any services from the provider listed, nor does it include any services rendered to you that are not identified here.
The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. There may be additional items or services I may recommend as part of your care that must be scheduled or requested separately and are not reflected in this Good Faith Estimate. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
You have the right to initiate a dispute resolution process if the actual amount charged to you substantially exceeds the estimated charges stated in your Good Faith Estimate (which means $400 or more beyond the estimated charges). You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
Emergency: 911 National Domestic Violence Hotline: 1- 800-799-7233 National Suicide Prevention Lifeline: 1-800-273-TALK (8255) National Hopeline Network: 1-800-SUICIDE (800-784-2433) Crisis Text Line: Text “DESERVE” TO 741-741 Lifeline Crisis Chat (Online live messaging):https://suicidepreventionlifeline.org/chat/ Self-Harm Hotline: 1-800-DONT CUT (1-800-366-8288) Essential local and community services: 211, https://www.211.org/ Planned Parenthood Hotline: 1-800-230-PLAN (7526) American Association of Poison Control Centers: 1-800-222-1222 National Council on Alcoholism & Drug Dependency Hope Line: 1-800-622-2255 National Crisis Line – Anorexia and Bulimia: 1-800-233-4357 GLBT Hotline: 1-888-843-4564 TREVOR Crisis Hotline: 1-866-488-7386 AIDS Crisis Line: 1-800-221-7044 Veterans Crisis Line:https://www.veteranscrisisline.net TransLifeline: https://www.translifeline.org – 877-565-8860 Suicide Prevention Wiki:http://suicideprevention.wikia.com
Above list retrieved from BetterHelp.com on 11/11/20
Lately our environments have been in flux in many challenging ways. Our daily routines, plans for the future, interpersonal relationships, and sense of self have all been destabilized. I am available to help ground you during this time, providing confidential therapeutic sessions from the privacy of your own home. I specialize in treating anxiety and depression, particularly in response to traumatic experiences. I offer individual psychotherapy sessions, as well as yoga and dance instruction on a sliding scale. I also provide live video, phone, and chat counseling sessions through BetterHelp. Wellness is dynamic, and I would be honored to help you move forward. To book a session or for more information, fill out the form below:
I am available for private lessons in-home or via Zoom, as well as in-studio through New Orleans Dance Academy. Email me at renee.gaubert@gmail.com for more info. Click below to register for group studio classes. Let’s move!
Renée Gaubert, LCSW 
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