Client Portal
Good Faith Estimate Notice
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.
You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
Payment:
Payment is acceptable by cash, check and credit card. Please contact us if you have any questions about fees. Insurance is not accepted, but we could provide you with a monthly statement (called a Superbill) which you may then submit to your insurance carrier for reimbursement.
Cancellation Policy:
A weekly scheduled appointment is reserved for you, meaning you are responsible for holding to that appointment time. Cancellations require no less than 24 hours notice prior to your scheduled session time. If your appointment is not cancelled within the required time period, you will be charged the full fee for your session. In the event of a medical emergency or an emergency involving a threat to your safety or the safety of others, please call 911 to request emergency assistance.
For any scheduling issues, you may contact us by telephone or email. For all clinical questions or concerns, please contact us by telephone only. If we are not immediately available, please leave a voice message and we will return your call as soon as possible.
Further, please be aware that in order to make progress, a commitment to attend and work on the issues that brought you into treatment is necessary.
Contact us.
citrineccinc@gmail.com
(747) 247-2597
13949 Ventura Blvd. Suite 210
Sherman Oaks, CA 91423