No Surprises Act / Good Faith Estimate

Last Updated: November 2025

Clarity Counseling (“we,” “us,” or “our”) is committed to protecting your privacy and ensuring transparency in how we collect, use, and disclose information. This Privacy Policy and No Surprises Act Notice outlines our practices in compliance with HIPAA, Virginia state law, and federal regulations.

No Surprises Act Notice
The No Surprises Act (effective January 1, 2022) provides federal protections against unexpected medical bills. As a mental health provider, Clarity Counseling complies fully with this law to ensure transparency in billing and costs.

Your Rights and Protections
You are protected from:
- Surprise bills for emergency services, even if out-of-network.
- Out-of-network charges for certain non-emergency services provided at in-network facilities.
- Balance billing without prior notice and consent.

Good Faith Estimates for Self-Pay Clients
If you are uninsured or not using insurance, you are entitled to a Good Faith Estimate (GFE) of expected charges for services. You have the right to dispute a bill that exceeds your GFE by $400 or more.

How to Request a Good Faith Estimate
To request an estimate, contact us when scheduling or prior to your first appointment. We will provide a written estimate within required federal timeframes.

Billing and Dispute Process
If you believe you were billed incorrectly, you may initiate a dispute with the U.S. Department of Health & Human Services (HHS) or the Virginia Bureau of Insurance.

Contact Information
Clarity Counseling
Email: claritycounselingva@gmail.com
Phone: 571-318-9141
Address: 7150 Heritage Village Plaza, Unit 201 Gainesville, VA 20155