Good Faith Estimate

Your right to receive a Good Faith Estimate of expected charges under the No Surprise Act.

Chiropractic Wellness Center will provide a Good Faith Estimate (GFE) of how much our services will likely cost you upon your request. If you are paying us directly for your services and you schedule at least 3 days in advance, we will provide a written GFE within 1 day of your scheduling. If you schedule at least 10 days in advance, we will provide a written GFE within 3 business days after scheduling.

We will inform you in advance with a new GFE if we plan to increase our fees or we anticipate your cost exceeding your original GFE. If we don’t and we bill you more than $400 in excess of your GFE without informing you in advance, you will have the right to dispute our bill through a federal dispute resolution process. You will need to provide a copy of your GFE to open a dispute, so we recommend that you save and/or print your GFE for future reference.

To request a GFE, please contact us. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers or email them or call at 1-800-985-3059.