Here you can find our Good Faith Estimate information along with intake and insurance forms to download and complete before your first visit.
Good Faith Estimate
You have the right to receive a ‘Good Faith Estimate’ explaining how much your medical care will cost.
Under the law, healthcare providers must give clients who either don’t have insurance or are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
In order for us to provide you a Good Faith Estimate in writing at least 3 business days before your medical service or item, please reach out in advance at (412) 414-1988 to enable us to have the time and staffing to prepare this information for you. You can also ask us for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill. You may contact us to let us know the billed charges are $400 or more than the Good Faith Estimate and ask us to either update the bill to match your estimate, negotiate your bill, or inquire about monthly payment options. We suggest you save a copy or picture of your Good Faith Estimate in case it is needed.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call (412) 414-1988.
Cancellation and No-show Policy
We value your time as our client. We hope that you will also value the time of our therapists by calling our office if there is a reason that you are unable to keep your appointment. This time will be reallocated to someone who is in need of treatment. Available appointments are in high demand and your early cancellation will give our staff time to give another person the opportunity to have access to timely care.
Cancellations required within 24 hours of your appointment. Any late cancellation, reschedule, or no-show appointments are subject to the following fees:
First no-show: 50% of amount of scheduled session
Subsequent no-shows: full amount of scheduled session
This notice describes how health information may be used and disclosed, and how you can access it.
All participants in wellness exercise classes must sign this form before their first class.