Good Faith Estimate
Information for people who do not have health insurance or who do not plan to use insurance to pay for care.
You may ask for expected costs in writing
Under the federal No Surprises Act, health care providers generally must give clients who do not have insurance—or who are not using insurance to pay for care—a Good Faith Estimate of expected charges when care is scheduled or when an estimate is requested.
Ask for an estimate before you schedule a service. Keep your written estimate so you can compare it with future bills. An estimate is based on information known at the time and does not require you to receive care from this practice.
Current practice fee
Discussed during the complimentary consultation. Before scheduling services, Drisana will explain applicable fees and provide an individualized Good Faith Estimate when required.
Your individualized estimate will account for the anticipated frequency and duration of services discussed with Drisana.
If a bill is substantially higher than the estimate
A federal patient-provider dispute process may be available when a bill from a provider is at least $400 more than that provider’s Good Faith Estimate. Current eligibility, deadlines, and instructions are available from the Centers for Medicare & Medicaid Services.
Visit CMS: Know your rights when you are not using health insurance or call 1-800-985-3059 for current federal information.
Requesting an estimate
Call (415) 578-0708 to request an estimate. Please do not leave sensitive clinical details in voicemail.
A Good Faith Estimate is not a contract and does not require you to begin or continue treatment.