Clarity Cognitive Consultants LLC

700 Narragansett Park Drive, STE 100

Pawtucket, RI 02861

Good Faith Estimate Notice

Clarity Cognitive Consultants, LLC is a cash-pay practice only. We do not accept, bill, submit claims to, or participate with any commercial insurance plan, Medicare, Medicaid, or other third-party payer.

All services are self-pay. Payment is due according to the practice’s financial policy at the time of scheduling or service, as applicable.

You have the right to receive a Good Faith Estimate explaining the expected cost of your care before services are provided.

A Good Faith Estimate lists the services reasonably expected to be provided and the anticipated charges. It does not include services that are not reasonably anticipated, services requested after the estimate is issued, or charges from other clinicians, facilities, laboratories, imaging centers, pharmacies, or referral providers.

Current cash-pay service fees:

Comprehensive Adult Autism/ADHD Consultation —

Premium Speed Tier $1,550

Comprehensive Adult Autism/ADHD Consultation —

Standard Access Tier $950

Cognitive Baseline & MCI Screening Consultation —

Premium Speed Tier $1,150

Cognitive Baseline & MCI Screening Consultation —

Standard Access Tier $750

Brain Track Annual Monitoring

Subscription, $295 per year

Premium Speed Tier reports are generally delivered within 7–10 days after completion of all required clinical components.

Standard Access Tier reports are generally delivered within 21–28 days after completion of all required clinical components.

A personalized Good Faith Estimate will be provided before scheduled services and is available upon request.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.

Please keep a copy of your Good Faith Estimate for your records.

Contact Clarity Cognitive Consultants, LLC with questions about fees, payment expectations, or your estimate before services are provided.