Good Faith Estimate Disclaimer

You have the right to receive a Good Faith Estimate (GFE) explaining the expected cost of services you will receive at our practice, if you are uninsured, self-pay, or elect not to use insurance for any portion of your services. This estimate will detail the reasonably expected charges for all items and services we anticipate providing. Under this law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including occupational and speech therapy services. You can ask our practice for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. 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 https://www.cms.gov/nosurprises.

If you believe you’ve been wrongly billed, you may contact: The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800- 633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law.