FEES

Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act and its implementing regulations, health care providers and health care facilities are required to inform individuals who are not enrolled in a group health plan, or group or individual health insurance coverage, or a Federal health care program, or a Federal Employees Health Benefits (FEHB) program health benefits plan (uninsured individuals), or not seeking to file a claim with their group health plan, health insurance coverage, or FEHB health benefits plan (self-pay individuals) in writing (and may also provide it orally, if an uninsured (or self-pay) individual requests a good faith estimate in a method other than paper or electronically), of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

When working with with Tessa Gittleman, PLLC, your Good Faith Estimate can be determined by calculating:

-The time you have scheduled x the services and rates listed below

-No Sales or MN Provider Taxes, or Credit Card Fees will be included in your bills, and no charges without prior notice of purchase.

Due to the nature of responsive services that Tessa Gittleman provides, you might be charged a unique and separate contracted rate to ensure no one is surprised when the bill comes.