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Your rights

Good Faith Estimate:
know your costs first.

Under the federal No Surprises Act, you have the right to receive a written estimate of expected charges before you get care. Here's how it works.

Who has this right?

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost if you don't have insurance or you choose not to use your insurance (self-pay). Health care providers are required by law to give you an estimate of expected charges for medical services.

What the estimate covers

Your Good Faith Estimate covers the total expected cost of the non-emergency services you've scheduled or requested, including related costs such as examinations, X-rays and imaging, and treatment services provided at our clinic.

You can ask for a Good Faith Estimate before you schedule a service, or at any point while scheduling. Make sure your estimate is given to you in writing at least one business day before your service.

How to request yours

Call or text us and ask for a Good Faith Estimate. We'll prepare a written estimate for your scheduled services at no charge and with no obligation.

Call 813-978-0020

If your bill is higher than the estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through the federal patient-provider dispute resolution process. You generally must start the dispute process within 120 calendar days of the date on the bill. Save a copy or photo of your Good Faith Estimate.

Learn more

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

This page explains your right to request a written estimate. It is not a price list, a quote, or a guarantee of charges. Your written Good Faith Estimate is prepared individually based on the services you schedule.

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