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No Surprise Act
Instructions Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage.
Refine Psychiatry is out of network and isn’t covered under your health insurance plan network.
Care from our providers could cost you more than providers covered in your network. You can contact your health insurance plan to find an in-network provider.
If there isn’t one, your health plan might work out an agreement with this provider or another one.
To learn more about the Good Faith Estimate, please visit: www.cms.gov
Provider Information:
Dr. Jill Norman
NPI#1366817983
Dr. Ashley Pirozzi
NPI#1194109298
Dr. Ryan Scoggins
NPI#1780003731
Location of Services:
Dr. Norman
22 West Micheltorena,
Unit A East Santa Barbara,
CA 93101.
Dr. Pirozzi and Dr. Scoggins
15233 Ventura Blvd,
Suite #1208 Sherman Oaks,
CA 91403.
We believe in pricing transparency. Below are typical rates for our most common services, so you know exactly what to expect before your first appointment.
Child/Adolescent Initial Evaluation
CPT Code 90792
$900
Adult Initial Evaluation
CPT Code 90792
$700
Medication Management Appointments
CPT Code 99213, 99214, 99215
$300
Psychotherapy
CPT code 90833, 90836
$350
Know Your Rights
If you are billed for more than this Good Faith Estimate, you have the right to 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.