KINDRED OAK COUNSELING SERVICES, PLLC

Self pay sessions are $120 per hour.

Clients can set up payment via our online patient portal prior to session using their credit or debit card.

Some clients appreciate not having to deal with the awkward end of session payment process. Clients can add their payment information through their online client portal prior to session. Credit cards will not be charged until midnight the day of your scheduled appointment.

I currently accept Blue Cross Blue Shield of Texas.

It is preferred to have intake paperwork completed ahead of time so that we can make full use of our time together during the intake session. All intake paperwork can be completed online via the HIPAA compliant client portal. A link to create your client portal will be emailed to you after you have scheduled your intake appointment. Copies of the intake paperwork can also be emailed to you upon request for you to print, complete, scan, and send back prior to your appointment.

A copy of any current custody agreement must be on file prior to a child's first appointment.

The client portal can be accessed at https://kindredoak.clientsecure.me

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If it is your first time using the portal, a temporary password will be sent to you using the email you have provided. Please contact me if you have not received this email or are having difficulty accessing the portal.

You can contact me directly at (832) 856-4545 or bethany@kindredoakcounseling.com. I will usually be able to return your call within 24 hours. If you leave a message, please let me know what times would be best to call you back. After a brief consultation, we can discuss scheduling your first appointment. Online scheduling is available for established clients.

I prefer to use a telehealth platform through Simple Practice. When using a laptop or computer, you will only need a link. If you wish to use a phone or tablet, you will need to download the app. Here is more info regarding telehealth through Simple Practice: https://support.simplepractice.com/hc/en-us/articles/360003183011-Telehealth-FAQs-for-clients

Under the No Surprises Act (H.R. 133 - which will go into effect on January 1, 2022), health care providers need to give clients or patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

• This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes (under the law/when applicable) related costs like medical tests, prescription drugs, equipment, and hospital fees.

• The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

  • You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

  • There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

• Make sure your health care provider gives you a Good Faith Estimate within the following timeframes:

  • If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;

  • If the service is scheduled at least 10 business days before the appointment date, no later than three business days after the date of scheduling; or

  • If the uninsured or self-pay patient requests a good faith estimate (without scheduling the service), no later than three business days after the date of the request. A new good faith estimate must be provided, within the specified time frames if the patient reschedules the requested item or service.

• Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment.

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To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.

If you have questions or concerns, please reach out.​​​​​​

CONSUMER RIGHTS & INSTRUCTIONS

(Required Notice - Texas Health & Safety Code §181.105)

1. Requesting Your Health Records

You have the right to request a copy of your health care records.

To request records, submit a written and signed request to either of the following:​​

Email: bethany@kindredoakcounseling.com

Address: PO Box 2079, Willis, TX 77378

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2. Contact the Licensing/Oversight Authority

Texas Behavioral Health Executive Council (BHEC)

Oversees licensed mental health professionals in Texas

Website: https://bhec.texas.gov

Phone: (800) 821-3205 or (512) 305-7700

Address: 1801 Congress Ave., Ste 7.300, Austin, TX 78701

3. File a Consumer Complaint

Texas Office of the Attorney General - Consumer Protection Division

File a complaint online at:

https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint

Consumer Protection Hotline: (800) 621-0508

Mailing Address: PO Box 12548, Austin, TX 78711-2548

This notice is posted in compliance with Texas House Bill 4224 (Effective September 1, 2025)