Patient Rights
Federal and Texas law give you important protections around billing and care. Here's what you need to know.
Your rights, clearly stated.
Good Faith Estimate
You have the right to receive a Good Faith Estimate before receiving care. If you are uninsured or choosing not to use your insurance, we are required by law to give you a written estimate of expected costs before your first appointment — or any time you ask.
What it covers
A Good Faith Estimate includes the expected cost of services we anticipate providing, including program fees, clinical sessions, and any medical services scheduled through our practice. It is not a final bill — your actual costs may differ based on the care you receive.
Your right to dispute
If you receive a final bill that is $400 or more above your Good Faith Estimate, you have the right to dispute that bill. You must initiate a dispute within 120 calendar days of receiving the bill.
How to request an estimate
Contact us before scheduling and we'll provide one within the required timeframe.
(817) 592-2500 · [email protected]
More info: www.cms.gov/nosurprises
Your Rights Against Surprise Medical Bills
When you get emergency care or are treated by an out-of-network provider at an in-network facility, you are protected from balance billing. You shouldn't be charged more than your plan's copayments, coinsurance, and/or deductible.
What is balance billing?
If you see an out-of-network provider, they may bill you for the difference between what your insurance pays and the full amount charged. This is called "balance billing" — and in many situations, it's prohibited by law. "Surprise billing" is an unexpected balance bill when you couldn't control who provided your care.
Texas and federal law protect you from surprise bills for:
- Emergency services
- Air ambulance services
- Care at an in-network hospital or facility from an out-of-network provider
- Labs and imaging ordered by an in-network provider
These protections apply to anyone with health insurance, except Medicare.
When balance billing isn't allowed, you also have the right to:
- Pay only your in-network cost-sharing amount — your health plan pays the rest.
- Have emergency services covered without prior authorization.
- Have out-of-network emergency costs count toward your in-network deductible and out-of-pocket limit.
If you think you've been wrongly billed
- Texas Department of Insurance: 1-800-252-3439 · tdi.texas.gov
- Federal (CMS): 1-800-985-3059 · cms.gov/nosurprises/consumers
- Texas Attorney General: 512-463-2100
Non-Discrimination Notice
Therapeutic Freedom TX complies with applicable Federal civil rights laws and does not discriminate based on race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)). Therapeutic Freedom TX does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.
Accessible services
Therapeutic Freedom TX provides:
- Reasonable modifications and free auxiliary aids and services for people with disabilities, including:
- Qualified sign language interpreters
- Written information in alternate formats (large print, audio, accessible electronic formats)
- Free language assistance for people whose primary language is not English, including:
- Qualified interpreters
- Information written in other languages
How to file a grievance
If you believe Therapeutic Freedom TX has failed to provide these services or discriminated based on race, color, national origin, age, disability, or sex, you may file a grievance with:
305 Regency Pkwy., Ste. 805, Mansfield, TX 76063
(817) 592-2500 · [email protected]
You may file in person, by mail, phone, or email.
Federal civil rights complaint
You may also file with the U.S. Department of Health and Human Services, Office for Civil Rights at the OCR Complaint Portal, or:
1-800-368-1019 · 800-537-7697 (TDD)
Complaint forms: www.hhs.gov/ocr/office/file/index.html