Good Faith Estimate

Standard Notice

 Under the No Surprises Act (Section 2799B-6), health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. 

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. 
  • Your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose for a Good Faith Estimate before you schedule an item or service.
  • You can dispute the bill if you receive a bill that is at least $400 more than your Good Faith Estimate. 
  • Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.

Will I receive one?

Dr. Phua will provide you with a good faith estimate once you schedule for an intake session. 

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