Your right to a Good Faith Estimate
If you do not have health insurance, or you plan to pay for care without using your insurance, you may be entitled to a written Good Faith Estimate of your expected charges under the No Surprises Act.
A Good Faith Estimate explains the expected cost of the health care items and services included in your care. Ask each provider or facility involved in your care for an estimate. It may not include services scheduled separately or unexpected care that could not reasonably have been anticipated.
When to expect your estimate
You can request an estimate before scheduling. For care that qualifies under the federal rules:
- If you schedule 3–9 business days ahead, the estimate is due within 1 business day after scheduling.
- If you schedule 10 or more business days ahead, the estimate is due within 3 business days after scheduling.
- If you request an estimate before scheduling, it is due within 3 business days after your request.
If your bill is higher
Keep a copy of your estimate. If a bill from a provider or facility is at least $400 higher than that provider's or facility's estimate, you may qualify for the federal patient-provider dispute resolution process. Generally, you must start that process within 120 calendar days of the date on your initial bill.
Questions about an estimate
To ask about an estimate for care at Van Metre Chiropractic, call 623-209-2225 or contact the office at 13927 W. Grand Ave., Suite 402, Surprise, AZ 85374.
For information about your federal rights, visit CMS No Surprises resources or call 1-800-985-3059. You can also read how to dispute a medical bill.