Good Faith Estimate

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Your Rights & What to Expect at 406 Therapeutics LLC

At 406 Therapeutics LLC, I want you to feel informed, respected, and empowered—both financially and emotionally. As part of the No Surprises Act, you have the right to receive a Good Faith Estimate that explains the expected cost of your mental health services.

What This Means for You

• You can ask for a Good Faith Estimate anytime—before scheduling or during your care.
• If you ever receive a bill that is $400 or more than your Good Faith Estimate, you have the right to dispute it.
• You’re encouraged to keep a copy of your estimate for your records.

My goal is transparency and support every step of the way.

Estimated Cost of Therapy Services

Service: Individual Psychotherapy
Length: 50–60 minutes
Fee per Session: $200

The number of sessions you attend is completely up to your needs, goals, and comfort level. Every person is different. Some prefer short-term support, while others benefit from longer-term therapy.

Typical yearly cost ranges:

• Brief support: 8 sessions × $200 = $1,600
• Moderate support: 26 sessions × $200 = $5,200
• Ongoing support: 52 sessions × $200 = $10,400

The above estimate is only an estimate and not a guaranteed total. Your actual charges will depend on the services you receive. If you qualify for a sliding scale rate, your fees may be adjusted accordingly and will be discussed with you in advance.

If You Ever Have Concerns About a Bill

If a bill ever comes in $400+ higher than your Good Faith Estimate, you can start a dispute process with the U.S. Department of Health and Human Services.

More information is available at www.cms.gov/nosurprises
or by calling 1-800-985-3059.

Effective Date: September 1, 2025
Last Updated: November 19, 2025

At 406 Therapeutics LLC, your privacy is extremely important to us. This Privacy Policy explains how we collect, use, and protect your information when you visit our website or communicate with us online.

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1. Information We Collect
We may collect the following types of information:
Personal Information: Information you voluntarily provide (such as your name, phone number, or email address) when you fill out a contact form, request an appointment, or communicate with us.
Non-Personal Information: Data automatically collected through cookies or analytics tools (such as your browser type, IP address, and pages visited) to help us improve our website and user experience.

We do not collect or store therapy notes, clinical records, or any protected health information (PHI) through this website.

2. How We Use Your Information
We use the information you provide to:
Respond to inquiries or appointment requests
Communicate about scheduling or services
Improve website performance and accessibility

We will never sell, rent, or share your personal information with third parties for marketing purposes.

3. Use of Email and Online Communication
Please note that messages sent through our website or regular email may not be fully secure. For your protection, avoid sharing sensitive health information through unencrypted online forms or email. Secure communication will be arranged once you become a client.

4. Cookies and Analytics
Our website may use cookies or third-party analytics tools (like Google Analytics) to understand how visitors use our site. You can disable cookies through your browser settings if you prefer not to share this information.

5. Data Security
We take reasonable administratilve and technical measures to protect your information from unauthorized access or disclosure. However, no online system is completely secure.

6. Links to Other Websites
Our website may contain links to other sites. We are not responsible for the content or privacy practices of those websites.

7. Your Rights
You have the right to:
Request access to the personal information we hold about you
Request correction or deletion of your personal data (where applicable)
Withdraw consent for us to contact you

To exercise these rights, please contact us at aatkins406@gmail.com

8. HIPAA Notice
If you become a client, your health information will be protected under the Health Insurance Portability and Accountability Act (HIPAA). You will receive a separate Notice of Privacy Practices explaining how your protected health information (PHI) is used and disclosed for clinical and administrative purposes.

9. Updates to This Policy
We may update this Privacy Policy periodically. The most current version will always be posted on our website.

10. Contact Us
If you have questions about this Privacy Policy or our privacy practices, please contact:

406 Therapeutics LLC
30 E Washington St

Ste C
Kalispell, MT 59901
aatkins406@gmail.com
406-260-5257

Effective Date: September 1, 2025

406 Therapeutics LLC
30 E Washington St

Ste C

Kalispell, MT 59901

406-260-5257

406therapeutics.com

Your Privacy Matters

Your privacy is important to me. This notice explains how your health information may be used and shared, and how you can access it. Please take a moment to read through — it’s your right to understand how your information is protected.

Your Rights

You have the right to:
See or get a copy of your record — You can ask for an electronic or paper copy of your therapy record.
Request a correction — If something isn’t right, you can ask to have it corrected.
Request confidential communication — You can choose how and where I contact you (for example, by phone only, or at a specific address).
Ask for limits on what is shared — You can request that I don’t share certain information. I’ll consider your request whenever possible.
Get a list of disclosures — You can ask who your information has been shared with and why (excluding routine care, billing, or operations).
Get a copy of this notice — You can always ask for a paper copy, even if you read it online.
Choose someone to act for you — If you have a guardian or medical power of attorney, that person can make privacy choices for you.
File a complaint — If you believe your privacy rights were violated, you can file a complaint with me or with the U.S. Department of Health and Human Services (HHS).

I will never retaliate against you for filing a complaint.

To file a complaint or ask questions:
Ashley Atkins, LCSW — 406 Therapeutics LLC
aatkins406@gmail.com

406-260-5257
or file with HHS at: www.hhs.gov/ocr/privacy/hipaa/complaints

Your Choices

You have a say in how I share your information. You can tell me your preferences about:
Sharing with family members or others involved in your care
Sharing information in an emergency or disaster situation

I will never share your information for:
Marketing or sales purposes

Fundraising efforts

How Your Information Is Used

Your information may be used in the following ways:
For treatment — To provide, coordinate, or manage your care.
Example: Sharing information with your doctor or another therapist at your request.
For payment — To bill and receive payment from insurance or other payers.
Example: Sharing information with your insurance company to verify coverage.
For operations — To improve services and manage the practice.
Example: Reviewing records for quality ⁶l compliance.

Other Situations Where Information May Be Shared

Sometimes, I’m legally required to share information. Examples include:
Reporting suspected abuse or neglect
Responding to court orders or legal requests
Protecting public health or safety
Workers’ compensation or law enforcement matters

If I need to share your information for any other reason, I’ll ask for your written permission first — and you can withdraw that permission anytime.

My Responsibilities

I’m required by law to protect the privacy and security of your health information (PHI).
I’ll let you know right away if there’s a breach that may have exposed your information.
I must follow the practices described in this notice.
I won’t use or share your information without your written permission unless the law allows me to.

Changes to This Notice

This notice may be updated from time to time. The most recent version will always be posted here on my website and available upon request.

Questions or Concerns?

I’m happy to answer any questions you may have about your privacy or this policy.

Contact:

Ashley Atkins, LCSW
406 Therapeutics LLC
aatkins406@gmail.com 

406-260-5257

Please note that any messages sent through this website or its contact forms are not secure or HIPAA-compliant. While I make every effort to protect your privacy, confidentiality cannot be guaranteed through email or website messaging. For confidential or urgent matters, please contact me directly by phone or schedule an appointment through secure, HIPAA-compliant platforms.