Connected Roots Teletherapy LLC
Good Faith Estimate
Your right to clear, upfront information about the cost of your care.
At Connected Roots Teletherapy LLC, my priority is to offer person-centered, transparent care so you can feel informed and supported from the start. I accept Medicare Part B and bill it directly, and private pay remains available for those who prefer not to use insurance. Whether you are paying privately or choosing not to use your Medicare Part B benefits for your sessions, you have the right to receive a Good Faith Estimate of the expected cost of your therapy services before we begin.
What is a Good Faith Estimate?
A Good Faith Estimate is a written summary of the expected costs of your mental health services. It is meant to help you understand and plan for the financial side of therapy, so there are fewer surprises as we work together.
Your rights under the No Surprises Act
Under the federal No Surprises Act, which went into effect on January 1, 2022, healthcare providers are required to give uninsured, self-pay clients, or those choosing not to use their insurance (including Medicare Part B) a Good Faith Estimate of expected costs before services begin. This applies to teletherapy as well as in-person care. While these specific protections apply to clients who are not using insurance for their sessions, I also accept clients who are using their Medicare Part B coverage, and the Good Faith Estimate applies when Medicare Part B clients are paying privately and not using their insurance benefits for therapy.
If you are paying out of pocket, not using insurance, or choosing not to use your Medicare Part B benefits for therapy, you can request a Good Faith Estimate at any time before scheduling a new service, or at any point in your work with me. Whether you are a private pay client or have Medicare Part B coverage, I am committed to making this information clear and accessible so you can make informed choices about your care.
What your estimate will include
Your Good Faith Estimate will outline the expected cost of therapy based on my current private pay rates and the number of sessions we anticipate. Because therapy is person-centered and tailored to your needs, the number of sessions we plan for will take into account your goals and preferences, whether you are seeking support as an individual, couple, or family.
The estimate will typically include:
- The type of service (for example, individual teletherapy, couples teletherapy, or family teletherapy)
- The fee per session
- The number of sessions we reasonably expect over a set period of time (such as 3 months or 12 months)
- The total estimated cost for that period
Estimates, changes, and your options
A Good Faith Estimate is not a contract or a guarantee. It is my best understanding, at the time we create it, of what your care may cost if we continue at a similar pace and frequency. Your actual costs may be different if we decide together to meet more or less often, adjust session length, or change the type of service you are receiving.
If your needs, goals, or circumstances change, we will revisit and update your estimate so it continues to reflect what feels right for you.
If your bill is higher than your estimate
If you receive a bill that is at least $400 more than the amount listed on your Good Faith Estimate, you have the right to dispute the bill. You can request that the bill be reviewed and that the difference be addressed.
To begin this process, you would typically contact the provider listed on your estimate and, if needed, follow the formal dispute process described in the No Surprises Act. I am always open to talking through any billing questions or concerns with you directly first.
Questions or request a Good Faith Estimate
If you have questions about your Good Faith Estimate, want to request one before starting, or would like to talk about what therapy might look like for you, please reach out. Teletherapy offers flexible scheduling and the ease of meeting from your own space, and we can explore together what kind of support feels most helpful.
Contact: Veronica Deglman, LMFT
Connected Roots Teletherapy LLC
Phone: (320) 335-6443
Address: 20 15th St #1056, St. Cloud, MN 56301
You are welcome to contact me with any questions about costs, estimates, or getting started with therapy. I am here to help you understand your options and to support you in making choices that feel right for you and your budget.
Connected Roots Teletherapy LLC 