Good Faith Estimate (No Surprises Act)

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

Under federal law, health care providers must give clients who do not have insurance, or who choose not to use insurance, an estimate of the expected charges for services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services. This includes related costs such as tests, prescription drugs, equipment, or hospital fees, if applicable.

You can request a Good Faith Estimate:

  • Before scheduling a service

  • At least 1 business day before your appointment

If you receive a bill that is $400 or more above your Good Faith Estimate, you have the right to dispute the bill.

For more information about your rights, visit www.cms.gov/nosurprises or call 800-985-3059..

Privacy & Confidentiality (HIPAA)

Your privacy is important. Federal law, known as the Health Insurance Portability and Accountability Act (HIPAA), protects your health information and outlines how it may be used or shared.

I am required by law to maintain the privacy of your Protected Health Information (PHI) and to provide you with a detailed Notice of Privacy Practices. This document explains how your information may be used for treatment, payment, and health care operations, as well as your rights regarding that information. You will receive this full notice as part of your intake paperwork. 

Limits to Confidentiality

Therapy is confidential, but there are situations where I am legally required or permitted to share information without your written authorization:

  • Risk of Harm: If there is a clear and immediate risk of serious harm to you or someone else, I may need to take steps to ensure safety, which could include contacting emergency services or notifying someone who can help.

  • Abuse or Neglect: I am required by law to report suspected abuse or neglect of a child, vulnerable adult, or dependent adult.

  • Court Orders or Legal Proceedings: A court may order the release of records.

  • Health Oversight: Government agencies may request information for lawful oversight activities.

  • Professional Consultation or Business Operations: I may share limited information with professional consultants or service providers (such as billing or electronic record systems) who are required to protect your privacy.

  • Legal Defense: If a client files a complaint or legal action against me, I may disclose relevant information to defend myself.

Whenever possible, I will discuss any necessary disclosures with you.

Your Rights

You have important rights regarding your health information, including the right to:

  • Receive ethical treatment without discrimination

  • Request limits on how your information is shared

  • Request confidential communication by alternative means

  • Inspect or obtain a copy of your records (with some limitations)

  • Request corrections to your records

  • Receive an accounting of certain disclosures

  • Choose someone to act on your behalf if legally authorized

  • Stop therapy at any time

These rights are explained in more detail in the Notice of Privacy Practices you will receive at intake.

Questions or Complaints

If you have questions about your privacy rights or how your information is handled, you are encouraged to discuss them with me directly.

You may also file a complaint with:

  • The U.S. Department of Health & Human Services

  • The appropriate North Carolina licensing board or health department

You will not be penalized for filing a complaint.