No Surprises Act

Breaking OCD, led by Lindsey Benolken, LPC, provides a good faith estimate for services offered to clients without insurance, in compliance with the No Surprises Act.

Disclaimer:

This Good Faith Estimate outlines the expected costs of items and services reasonably anticipated for your mental health care needs. The estimate is based on the information available at the time it was created. It does not include any unforeseen or additional costs that may arise during your treatment. If complications or special circumstances occur, you may be charged more.

If you receive a bill that exceeds this Good Faith Estimate, you have the right to dispute the charges. You may contact Breaking OCD directly to discuss the bill, request an updated bill that matches the estimate, negotiate the charges, or inquire about financial assistance options.

You may also initiate a dispute resolution process through the U.S. Department of Health and Human Services (HHS). To use this process, you must file the dispute within 120 calendar days (approximately 4 months) from the date on the original bill. There is a $25 fee to begin the dispute process. If the dispute resolution agency rules in your favor, you will only be responsible for paying the amount on the Good Faith Estimate. If the agency sides with Breaking OCD, you will be responsible for the higher amount.

For more information and to access the dispute form, please visit www.cms.gov/nosurprises.

Contact:
Email: Lindsey@breakingocd.com

Clients must reside in Arizona, Minnesota, New Mexico, or Florida at the time of treatment for virtual services, or be local to Arizona for in-person sessions.