Legacy Clinic of Chiropractic

Good Faith Estimate

Chiropractors in Villages

Good Faith Estimate Notice

The Good Faith Estimate is a provision of the No Surprises Act (NSA) designed to provide consumers predictability of how much they will be charged for the healthcare services they will receive before their appointment. Under the law, healthcare providers must give their patients an estimate of the bill for medical items and services.

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

Know Your Rights

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

What Providers and Facilities Are Required to Do

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling.
  • If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling.
  • You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
  • 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 more information about your right to a Good Faith Estimate, please visit www.cms.gov/nosurprises or call 1-800-985-3059.

Good Faith Estimate Notice | (352) 259-0024