PATIENT BILLING RIGHTS
Your Right to a Good Faith Estimate
For uninsured patients and patients paying for care themselves.
You can request a written estimate of expected charges for non-emergency health care before scheduling. Providers must also supply estimates when qualifying care is scheduled in advance.
For care scheduled 3–9 business days ahead, the estimate is generally due within 1 business day after scheduling; for 10 or more business days ahead, within 3 business days. An estimate requested before scheduling is generally due within 3 business days.
The estimate should describe expected items, services, and related charges. Keep a copy. A bill from a provider that is at least $400 above that provider’s estimate may qualify for the federal patient–provider dispute process.
Ask our office for an estimate or help understanding your expected charges.
Imagination Orthodontics
990 Cedar Bridge Avenue, Suite B15, Brick, NJ 08723
(732) 477-1808 · info@imaginationorthodontics.com
Learn more at CMS patient billing rights or call 1-800-985-3059.
