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Good Faith Estimate

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Understanding expected charges

If you are uninsured or choose not to use insurance, you generally have a right to a written estimate of expected healthcare charges. Ask when scheduling or before deciding on care. A Good Faith Estimate is not a bill or a guarantee that unexpected additional care will never be needed.

Request an estimate

Tell the clinic you will be self-paying and ask for an estimate in writing. Estimates generally apply when care is scheduled at least three business days ahead or when requested. Emergency care is excluded. This contact form does not generate an estimate or book a visit. Ask each provider or facility involved for its own estimate and keep a copy.

When to expect the written estimate

For care scheduled 3–9 business days ahead, the estimate is generally due within one business day of scheduling. With at least 10 business days’ notice, it is generally due within three business days. If you request an estimate before scheduling, it is generally due within three business days. Keep the estimate to compare with the bill.

If the bill differs

If a provider’s bill is at least $400 above that provider’s estimate, you may qualify for the federal patient–provider dispute process. It generally must be started within 120 calendar days of the initial bill. Review eligibility and current instructions with CMS; contact the clinic with billing questions.

Official information

CMS — medical bill rights · Dispute eligibility and instructions

Contact the clinic

Schroeder Family Wellness Clinic, 421 E 30th Ave, Hutchinson, KS 67502. (620) 663-2678. [email protected].