Good Faith Estimate
Your Right to an Estimate of Expected Charges
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If you do not have health insurance—or choose not to use insurance for your care—you are generally entitled to receive a Good Faith Estimate explaining the expected cost of your services.
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You may also request an estimate before scheduling. When required, All Things New Clinical Services will provide the estimate within the timeframe established by applicable law, using the information available at that time.
What Your Estimate May Include
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Your Good Faith Estimate may include:
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Your name and identifying information;
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Information about the Practice and treating clinician;
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Descriptions of the expected services and applicable billing codes;
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The anticipated frequency or number of services known at the time;
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The expected charge for each service and estimated total cost; and
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Disclaimers explaining that treatment needs, services, and costs may change.
An Estimate Is Not a Fixed Treatment Plan
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A Good Faith Estimate is not a contract and does not require you to receive services from the Practice.
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Therapy needs may change after treatment begins. You and your clinician may adjust the frequency, duration, or type of service based on clinical need, your preferences, scheduling, or other circumstances.
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If the expected scope or cost of your care changes substantially, you may request an updated estimate.
If Your Bill Is Substantially Higher Than the Estimate
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Federal law provides a patient-provider dispute-resolution process when a billed charge is at least $400 more than the amount listed in your Good Faith Estimate.
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Please contact All Things New Clinical Services first if you believe a bill is incorrect or does not match your estimate.
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For current information about Good Faith Estimates and patient-provider dispute rights, visit the U.S. Centers for Medicare & Medicaid Services website or call 1-800-985-3059.
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Link: Learn About Good Faith Estimates
https://www.cms.gov/medical-bill-rights/help/guides/good-faith-estimate