COVID Policy

Please DO NOT COME TO IN PERSON appointments if you have any of the following symptoms - FEVER above 98.6, coughing, sneezing, runny nose, sore throat, loss of taste or smell or have been exposed to someone who is exhibiting these symptoms or has tested positive within 72 hours of our scheduled appointment. I am happy to keep the appointment via Telehealth ONLY if you have symptoms or have been exposed.

No Surprises Act/ Good Faith Estimate

Kifferie Corley, MA, LPC, ADS dba Galveston Marriage and Family Counseling

305 21st Street Suite 251, Galveston, TX 77550

(832)819-4604, kifferie@galvestonmarriageandfamilycounseling.com, www.galvestonmarriageandfamilycounseling.com 

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE

 MEDICAL BILLS

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs,     such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable  condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections  not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance  bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following  protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

  • Your health plan generally must:

    • Cover emergency services without requiring you to get approval for services in advance (prior authorization).

    • Cover emergency services by out-of-network providers.

    • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

    • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact: 

    Please call 1-800-821-3205

    https://www.bhec. texas.gov/discipline-and-complaints

    Texas Behavioral Health Executive Council

    333 Guadalupe St . ,Ste. 3-900 Austin, Texas 78701

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.  

 For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call (800) 368-1019. 

Visit https://www.bhec. texas.gov/discipline-and-complaints

for more information about your rights under Texas Laws.

Late Cancellation/No Show

Cancellation PolicyI understand that unanticipated events happen occasionally in everyone’s life. In my desire to be effective and fair to all clients, the following policies are honored:
24 hour advance notice is required when canceling an appointment. This allows the opportunity for someone else to schedule an appointment. If you are unable to give us 24 hours advance notice you will be charged 100% of the full amount of your scheduled appointment. This amount will immediately be charged to your credit card on file prior to your next scheduled appointment. If the transaction is not completed within 24 hours, the client will not be allowed to reschedule until the fee is paid in its entirety.
No-showsAnyone who either forgets or consciously chooses to forgo their appointment for whatever reason will be considered a “no-show.” They will be charged a service fee equal to 100% of their "missed” appointment via the credit card on file. If the transaction is not completed within 24 hours, the client will not be allowed to reschedule until the fee is paid in its entirety.
Late ArrivalsIf you arrive late, your session may be shortened in order to accommodate others whose appointments follow yours. 15 minutes past your scheduled appointment time is the maximum amount of late time that will be accepted to continue the appointment. Regardless of the length of the session actually given, you will be responsible for the “full” price of the session. Out of respect and consideration to your therapist and other customers, please plan accordingly and be on time.