Your Right to a Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.

Under the law, health care providers need to give patients who don’t have certain types of health care coverage, or who are not using certain types of health care coverage, an estimate of their bill for health care items and services before those items or services are provided.

This is a private pay practice that does not bill insurance, so this applies to every client.

You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services.

If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider gives you a Good Faith Estimate in writing within 1 business day after scheduling.

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 www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

To request a Good Faith Estimate from this practice, email hello@drsarahlong.com or call 720-594-3208.