Transparency and Compliance
Good Faith Estimate (GFE)
Under federal law, every individual seeking care without using insurance has the right to a written estimate of expected costs before services begin. This page fulfills that notice requirement for all prospective clients of Alafiora.
Federal notice — No Surprises Act
The No Surprises Act (effective January 1, 2022) requires healthcare providers to give uninsured and self-pay individuals a Good Faith Estimate of expected charges before care begins. This requirement applies to all licensed psychologists and mental health providers, including those in private practice.
Alafiora is a private-pay practice. No insurance claims are filed on behalf of clients. Superbills are available upon request for those who wish to seek out-of-network reimbursement independently. Individuals who receive superbills and intend to submit them to insurance are also entitled to a Good Faith Estimate prior to services beginning.
The estimates provided here and in any written estimate shared at intake are based on information available at the time of scheduling. Actual costs may differ if the frequency, duration, or nature of services changes based on clinical need. Any substantive change to anticipated services will be accompanied by an updated estimate.
Service rates and billing codes
Total sessions
12
over 12 weeks
Weekly cost
$300
1 session/week
Monthly cost
$1,299
approx. 4 sessions/mo
Sessions subtotal
$3,600
12 sessions
This estimate does not include retainer costs, written documentation, late cancellation fees, or any services added based on clinical need. It is provided for planning purposes only, is not a contract, and does not obligate anyone to obtain services from Alafiora. Actual costs may vary based on the frequency, duration, and nature of care as it evolves clinically.
Monthly retainer
$9,500
per month
Duration
1
month
Retainer total
$9,500
retainer only
The concierge retainer is structured by clinical arrangement and covers a defined scope of access and care. This estimate reflects the monthly retainer rate only and does not include session fees, written documentation, or other services billed separately. It is provided for planning purposes only, is not a contract, and does not obligate anyone to obtain services from Alafiora.
Rates are subject to annual review. Current clients are notified in writing at least 30 days before any rate change takes effect. All Good Faith Estimates are reissued at the 12-month mark for clients in ongoing care, consistent with federal requirements.
Client rights under the No Surprises Act
Every individual seeking care without using insurance has the right to receive a written Good Faith Estimate of expected charges, available upon request and provided at or before scheduling.
If a bill is $400 or more above the Good Faith Estimate provided, the individual may initiate a dispute through the federal Patient-Provider Dispute Resolution process. Initiating that process will not affect the quality of care received.
A Good Faith Estimate is not a contract. Receiving one does not obligate anyone to obtain services from Alafiora or from any provider named in the estimate.
Good Faith Estimates apply to new clients, established clients, and to individuals who carry insurance but choose not to use it for these services.
For recurring services, an updated Good Faith Estimate will be issued at the 12-month mark or whenever there is a substantive change in anticipated frequency, duration, or service type.
For questions or to learn more about the dispute process, visit cms.gov/nosurprises or call 1-800-985-3059.
Request a written estimate
A written Good Faith Estimate, inclusive of all required federal elements, is provided to every client before or at the time their first session is scheduled. Prospective clients may also request one in advance of scheduling. Please reach out directly with any questions about anticipated costs or what care at Alafiora may involve.