Good Faith Estimate

Updated 3/8/2022

About Good Faith Estimates

 

Dear Patient,

 

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

 

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, examinations, office visits prescription drugs, and equipment (items or services reasonably expected to be furnished by this practice).

 

​​Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

 

​​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 https://www.cms.gov/nosurprises. To speak to our billing department, please call (310) 828-0011.

 

Thank you.

 

Your friends at University Foot and Ankle Institute.

 

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