Good Faith Estimate & Practice Notices

1. Your right to a Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your health care will cost. Under federal law, health care providers must give patients who do not have insurance or who are not using insurance an estimate of charges for medical items and services. This includes expected charges for non-emergency services and related items.

You may request a written Good Faith Estimate before scheduling. When you schedule services at least three business days in advance, the estimate generally must be provided within these federal timeframes:

• If services are scheduled 3–9 business days in advance: within one business day after scheduling.
• If services are scheduled at least 10 business days in advance: within three business days after scheduling.
• If you request an estimate without scheduling: within three business days after the request.

Ask your provider for an estimate and keep a copy or a photo. A Good Faith Estimate is not a contract requiring you to obtain services. Actual charges may differ if additional services are needed, but applicable notice and dispute rights still apply.

If you receive a bill from a provider that is at least $400 more than that provider’s Good Faith Estimate, you may be eligible for the federal patient-provider dispute resolution process. You generally must start that process within 120 calendar days of the date on the initial bill. Visit cms.gov/nosurprises or call 1-800-985-3059 for information about your rights and the dispute process.

2. Licensure and clinical supervision

Stevi Stanley, LMSW (Licensed Master Social Worker), practices under the clinical supervision of Dr. Dominique Spigner.

3. Licensing questions and complaints

For information about Texas social work licensing or how to file a complaint, contact the Texas Behavioral Health Executive Council (BHEC): 1801 Congress Avenue, Suite 7.300, Austin, TX 78701; telephone 512-305-7700. Current complaint instructions are available at bhec.texas.gov.

You may also contact the practice with concerns about services. Contacting the practice is not a prerequisite to filing a complaint with a licensing authority and does not limit any rights you have.

4. Clinical privacy and records

The website Privacy Policy concerns public website information and is not a substitute for clinical privacy notices or informed consent. Ask the practice through its secure client portal for information about clinical records, confidentiality, authorized disclosures, and access requests.

5. Evaluation and documentation limits

Evaluations are professional assessments, not guarantees of a particular diagnosis, report conclusion, benefit, leave approval, accommodation, or legal outcome. Tell the clinician about any required forms, third-party criteria, or deadlines through the secure intake process before services are arranged. The practice must confirm whether it can provide the requested service.

6. Contact and emergency help

Contact Turning Point Counseling & Wellness at 2309 Gilmer Rd, Ste 101, Longview, TX 75604, 430.342.9019 or stevistanley@gmail.com. Please do not include medical records or sensitive health information in ordinary email.

Public forms and email are not continuously monitored and are not appropriate for emergencies. If you or someone else is in immediate danger, call 911. For suicide or emotional crisis support, call or text 988.