No Surprises Act

If you do not have insurance or are choosing not to use insurance for an upcoming appointment to our practice, you are eligible to receive a Good Faith Estimate in writing.

A Good Faith Estimate lists the expected cost for items and services for your upcoming visit. The estimate is based on information known at the time the estimate was created.

The actual items, services, or costs may differ from those described in the estimate if unforeseen circumstances occur. Additional items or services may be recommended as part of your treatment plan that are not included in the estimate. Those additional items or services may be scheduled separately. Appointments must be scheduled at least 3 days in advance to be eligible to receive a good faith estimate.

If you are billed in excess of $400 of your estimate, you may dispute your bill here.

For questions or more information about your right to a Good Faith Estimate, click here.

Good Faith Estimate Flyer

To request a Good Faith Estimate, please call our office at 614-486-5200.