You may obtain a good faith estimate of my charges upon request prior to scheduling with me. The No Surprises Act is a federal law which provides us with the right to a good faith estimate of the cost of services at my practice. However, Ohio licensing board rules require me to provide you with the actual cost of my charges in a written informed consent form to which you must agree prior to our providing services. That will be available to you prior to you being seen for services and prior to any billing. In most cases it is impossible to estimate the number sessions you will need, and that will not be determined until your concerns are evaluated and will also vary based on the progress that you make, which depends in part on your efforts with the process. You will be free to discontinue services at any time or the services may otherwise be terminated in accordance with the informed consent form language. Although the No Surprises Law says that you may initiate a dispute process if the actual charges are substantially in excess of the Good Faith Estimated charges (i.e., if you are charged $400 more than the estimated cost for a session or for the total estimate provided), that is unlikely to happen and would be a violation of licensing board rules, since you will be agreeing up front to actual charges per session prior to being seen. Dispute information is available upon request, however. Any changes to our fees will require a change in the informed consent form fees, which you must agree to prior to having them go into effect, otherwise the fees will remain in effect for 12 months.
9900 Carver Road, Suite 101 Cincinnati, Ohio 45242
Irene B. Giessl, EdD, (513) 221-2001
Barbara J. Hensley, EdD, (513)-961-2400
FAX (513) 961-7444
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