Consumer Cost Protections

Good Faith Estimate & No Surprises Act

Your right to transparent pricing and estimated healthcare costs before treatment begins.

Emergency & Crisis Notice

THIS WEBSITE IS NOT FOR EMERGENCIES OR CRISIS INTERVENTION. If you or someone you know is experiencing a mental health crisis, suicidal thoughts, or immediate danger:

• Call or text 988 to reach the Suicide & Crisis Lifeline (24/7, free, confidential).
• Call 911 or go immediately to the nearest emergency room.
• In MA: Call the Behavioral Health Help Line at 833-773-2445.
• In RI: Call BHLink at 401-414-LINK (5465).

1. Your Right to a Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act (commonly referred to as the No Surprises Act), healthcare providers are required to give patients who do not have certain types of healthcare coverage, or who are not using insurance to pay for services, an estimate of expected charges for medical and mental health items and services before treatment begins.

You have the right to receive a written Good Faith Estimate (GFE) explaining the total expected cost of your non-emergency healthcare, including psychotherapy sessions with Rootwell Therapy & Consulting LLC.

2. Who This Applies to at Rootwell Therapy

Rootwell Therapy & Consulting LLC is an out-of-network, private-pay psychotherapy practice owned and operated by Regina Tetreault, LICSW. I am not paneled directly with commercial health insurance plans.

Therefore, the Good Faith Estimate requirement applies to:

• Clients who are uninsured.
• Clients who choose not to submit claims to their health insurance policy.
• Clients whose health insurance does not cover out-of-network mental health services.

If you plan to submit monthly itemized Superbills to your insurance carrier for out-of-network reimbursement, you are still paying Rootwell Therapy directly out-of-pocket, and you are entitled to a Good Faith Estimate.

3. When Your Good Faith Estimate Is Provided

By federal law, your written Good Faith Estimate must be provided according to the following timelines:

You can also request a Good Faith Estimate at any point during active therapy if your session frequency or service type changes.

4. What Your Good Faith Estimate Includes

Your personalized estimate will outline the expected cost of psychotherapy sessions based on the agreed-upon frequency (e.g., weekly, biweekly) and duration of treatment.

Current Standard Fee Structure:

5. Dispute Resolution Rights (If Billed Over Estimate)

Under federal law, if you receive a bill from Rootwell Therapy that is at least $400 more than the total expected cost on your written Good Faith Estimate, you have the right to dispute the bill through the federal Patient-Provider Dispute Resolution (PPDR) process.

• You must initiate the dispute process within 120 calendar days of the date on the unexpected bill.
• Initiating a dispute will not affect the quality or availability of your ongoing mental health care.
• An independent third-party entity will review your Good Faith Estimate, the bill, and clinical documentation to determine the appropriate payment amount.

6. Save Your Records

Make sure to save a copy or photo of your Good Faith Estimate and your clinical billing statements in a safe place.

7. Federal Information & Contact Resources

For questions or more information about your right to a Good Faith Estimate or the federal No Surprises Act:

Request a Good Faith Estimate

To request a custom Good Faith Estimate prior to scheduling, please reach out directly: