Clear information about the cost of care.
If you do not have insurance, or choose not to use it, you have the right to receive a written estimate of the expected cost of your care.
You deserve to understand the financial side of therapy.
A Good Faith Estimate helps you know what to expect before receiving care. It is based on the information available when the estimate is prepared, and your individualized estimate will be provided separately.
Your right to an estimate
You may ask for a written Good Faith Estimate before scheduling. When services are scheduled at least three business days in advance, you should generally receive an estimate before care begins.
What it includes
Your estimate describes the therapy services and expected charges known at the time. It may include assumptions about the anticipated timing or frequency of care.
It is not a bill
A Good Faith Estimate is not a contract and does not require you to receive services. The course of therapy may change as your needs, preferences, and circumstances become clearer.
Keep your documents
Save a copy of your estimate and any bills you receive. These records can help you compare the amount you expected with the amount you were charged.
You may have options for disputing a bill.
If a bill from a provider is at least $400 more than the Good Faith Estimate from that provider, you may be eligible to use the federal patient provider dispute resolution process. The process generally must be started within 120 days of the date on the initial bill.
Request your estimate.
Contact Elevate & Empower to request an individualized Good Faith Estimate or to ask a question about expected therapy costs.
Learn more about your rights.
Visit the Centers for Medicare & Medicaid Services Medical Bill Rights page, or call the federal No Surprises Help Desk at 1, 800, 985, 3059.
This page provides general information and is not legal advice. Your individual Good Faith Estimate contains the details that apply to your care. Federal and state requirements may change, so this page should be reviewed periodically for continued compliance.