GOOD FAITH ESTIMATE

At my practice, I am committed to transparency in pricing for patients who are paying out-of-pocket. Under the federal No Surprises Act of 2022, you have the right to receive a Good Faith Estimate (GFE) before your appointment.

A Good Faith Estimate is a written document that outlines the expected costs of your care, including evaluation, follow-up visits, and any anticipated services. If your treatment plan changes, I can provide an updated estimate. The estimate is not a contract and does not obligate you to obtain services from me. If you are billed $400 or more than the estimate, you have the right to dispute the bill.

Your understanding of expected costs helps you make informed decisions about your care. I am here to answer any questions you may have.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.