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Good Faith Estimate
Right to Receive a Good Faith Estimate of Expected Charges
Under the No Surprises Act
Federal law requires health care providers to give patients who are uninsured or self-pay a Good Faith Estimate of expected charges for services.
Who Receives a Good Faith Estimate (GFE)
You have the right to receive a GFE if you:
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Do not have insurance, or
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Choose not to use insurance for your care
What the estimate includes
Your Good Faith Estimate outlines the expected cost of therapy services based on the information available at the time it is prepared.
When you receive your estimate
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You will receive a Good Faith Estimate in writing at least one business day before services are scheduled.
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You may also request a Good Faith Estimate before scheduling a service.
If your bill is higher than your estimate
If you receive a bill that is $400 or more above your Good Faith Estimate, you have the right to dispute the bill.
More information is available at www.cms.gov/nosurprises or
by calling 1-877-696-6775.
We recommend saving a copy of your Good Faith Estimate for your records.
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