Writing a Good Faith Estimate (GFE) for therapists in private practice involves creating a clear, concise document that outlines the expected costs of services provided to clients, as required under the No Surprises Act. For therapists, this form helps ensure transparency in financial expectations and protects clients from unexpected costs. In this blog, we'll break down what “good faith” means and will review the good faith estimate requirements including how it is relevant to therapists, what is covered in a good faith estimate form, what should be included, and an example of GFE for therapists.
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What Is Good Faith in Simple Terms?
In simple terms, “good faith” refers to honesty and fairness in a transaction. When you provide a good faith estimate, you are offering a realistic projection of the expected costs for therapy services you plan to offer. It’s not a guarantee but rather a well-reasoned, accurate forecast of expenses, ensuring your client has a clear understanding of what they will owe based on your fees, services, and treatment length.
For therapists, this practice fosters trust and transparency, crucial elements in building a positive therapeutic relationship. Good faith estimates are particularly relevant in private practice, where clients pay out-of-pocket or choose not to use their insurance for services. This is required under the No Surprises Act, which was launched on January 1, 2022.
What Is a Good Faith Document for Therapists in Private Practice?
A Good Faith Estimate document is a requirement under the No Surprises Act, which applies to healthcare providers, including mental health professionals in private practice. The Act mandates that providers give self-pay clients and clients choosing not to use their insurance a detailed estimate of their expected charges before services are rendered. To meet good faith estimate requirements, your estimate must be in writing and presented to the client in a timely manner before their first appointment.
It is suggested that both therapist and client sign the document, but it isn’t required that the client sign it.
For therapists in private practice, the GFE is more than just a legal formality; this document informs clients of the costs associated with therapy, so they can make informed decisions about their therapeutic treatment with you.
In essence, a Good Faith Estimate document serves as a proactive step to clarify expectations between you and your clients. Thus, helping to avoid any financial misunderstandings down the road.
It also lists out your fees for other services that a client might choose to use or access.
What Is Usually Included in a GFE?
As therapists, we've created a well-prepared GFE for therapists that includes several key elements that ensure compliance and transparency. Below are the main components that should be part of your good faith estimate form for therapists in private practice:
Client Details: This section contains the client's full name, date of birth, contact information, and diagnosis if applicable or known.
Therapist Details: Includes the therapist's name, practice information, and contact details. Along with their EIN and NPI, if applicable.
Service Description: A comprehensive list of the therapy services to be provided, specifying the type of therapy (e.g., individual, couples, family), and the anticipated length of each session.
Cost Estimate: Breakdown of costs for each service, including the rate per session and the estimated total cost for the entire treatment plan.
Possible Extra Charges: A notice of any additional fees that could occur during treatment, such as charges for missed appointments, late cancellations, report writing, court appearances, or other services not initially covered in the estimate.
Good Faith Clause: A statement assuring that the estimate reflects the therapist's best efforts to predict costs based on the available information at the time of drafting.
Providing these details not only meets legal requirements but also offers clarity and peace of mind to your clients.
What Is a GFE Form Example?
An example of a Good Faith Estimate Template for Therapists could look like something like this. Please note that this is not a complete example, but rather an overview of items that need to go into a Good Faith Estimate Template.
Client Name:
Client Address:
Client Phone Number:
Client DOB:
Diagnosis (if known):
Therapist/Practice Name:
Therapist Contact Information:
Date of Estimate:
Description of Services:
50-minute individual therapy session: $150
Estimated number of sessions: 12
Total estimated cost: $1,800
Additional Fees (if applicable):
Late cancellation fee (less than 24 hours): $150
Record request fee - $1.25/page
Letter or report writing fee - $100/hour billed in 15-minute increments
Disclaimer: You need to have a disclaimer in it that also includes how to file a dispute.
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Looking for Other Essential Private Practice Paperwork?
Check out the Attorney-Approved Private Practice Paperwork Bundle for therapists from The Private Practice Startup. This bundle includes all the essential forms. Including the Good Faith Estimate template, designed to help you stay compliant and professional. Grab yours today: Private Practice Paperwork Peak Package.
Streamline Your Practice with a Free Good Faith Estimate Template
If you're looking for an Attorney-Approved Good Faith Estimate Template or a complete bundle of private practice paperwork, The Private Practice Startup has you covered! These resources ensure compliance with the latest legal requirements while building trust with your clients by providing clear, upfront information about therapy costs. Simplify your practice's paperwork in three easy steps:
Ask Any Questions – Email us at Kate@ThePrivatePracticeStartup.com for any inquiries or clarification on how the Good Faith Estimate Template can benefit your practice.
Grab Your Free Template – Download the Attorney-Approved Good Faith Estimate Template for therapists, or choose from our bundle of private practice paperwork, and customize it for your practice.
Start Using It Today – Once downloaded, add your practice information and start providing clear, compliant estimates to your clients immediately!
Additional Offerings from The Private Practice Startup
At The Private Practice Startup, we're dedicated to providing the resources you need to help your private practice succeed. In addition to our essential private practice paperwork, we offer supervision forms for mental health professionals, an in-depth Private Practice Marketing E-Course to help you attract and retain clients, and personalized coaching sessions with Kim Grocher, PhD, LCSW, designed to support your professional growth. Don’t miss our Private Practice Startup Podcast, where we interview industry experts, successful practitioners, and entrepreneurs to guide and inspire you through each stage of your private practice. No matter where you're located—be it Texas, California, New York, Florida, or anywhere in the U.S.—we’re here to help you succeed.