Good Faith Estimate

Wired to Connect Counseling PLLC

Wired to Connect Counseling PLLC
Owner: Rimma Isaac, LCPC
Location: Park Ridge, IL
Phone: 224-585-9849
Email: rimma.tsi@gmail.com

Effective Date: 6th June, 2025

In accordance with the No Surprises Act, I am providing this Good Faith Estimate to ensure that you have clear and transparent information about the expected cost of services at Wired to Connect Counseling PLLC. This document outlines the costs for therapy services and other related services at our practice.

Your Right to a Good Faith Estimate

As required by law, I am providing you with an estimate of the total expected costs for the services you may receive. This includes therapy services as well as any additional costs such as document requests or consultation fees.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes the following:

  • Individual Therapy
  • Couples Therapy
  • Family Therapy
  • First Responders Therapy
  • Trauma-Informed Coaching
  • Clinical Consultation & Supervision

How to Request a Good Faith Estimate

If you would like to receive a Good Faith Estimate, you can request one in writing at least 1 business day before your scheduled service. You may also request an estimate before scheduling any therapy services. I am happy to provide this information to ensure you are well-informed about the cost of treatment.

Estimated Cost of Services:

Service Estimated Cost per Session Session Length
Individual Therapy $150 55 minutes
Couples Therapy $200 55 minutes
Family Therapy $200 55 minutes
Trauma-Informed Coaching $200 55 minutes
Clinical Consultation & Supervision $150 55 minutes

Please note that these are estimates, and actual charges may vary depending on the type of service and the session length.

Disputing Unexpected Charges

If you receive a bill that is at least $400 more than the Good Faith Estimate provided to you, you have the right to dispute the charges. If you believe the charges are incorrect or do not align with the estimate, please reach out to us for clarification or assistance.

Payment Information:

  • Payments are due at the time of service.
  • I accept payments via cash, check, or credit card.

Cancellation Policy:

To provide the best care for all clients, I ask for at least 24 hours’ notice for cancellations or rescheduling. Late cancellations or missed appointments may be subject to the full session fee.

Save Your Good Faith Estimate

Be sure to keep a copy of your Good Faith Estimate for your records. This will ensure you have a clear understanding of the anticipated costs for therapy services and can refer to it if needed.

If you have any questions or concerns about the Good Faith Estimate or the services I offer, please don’t hesitate to reach out to us at 224-585-9849 or rimma.tsi@gmail.com.

By continuing with therapy at Wired to Connect Counseling PLLC, you acknowledge that you have received and understand the Good Faith Estimate provided for the services you will be receiving.