Good Faith Notice
Tri-Cities Skin & Cancer
Your Right to a Good Faith Estimate
Under the law, health care providers must give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. This is called a Good Faith Estimate.
You have the right to receive a Good Faith Estimate and Tri-Cities Skin & Cancer will provide one prior to your scheduled appointment.
The Good Faith Estimate shows a total expected cost of any non-emergency items or services, including pathology processed here at our office. This estimate is based on information known at the time the estimate was created.
You will receive a Good Faith Estimate in advance of an already scheduled medical service or item. You may also request an estimate before scheduling an appointment. The estimate will be provided within three business days of the request.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.
PLEASE BE AWARE:
- A change in the treatment plan first discussed
- Finding of an additional diagnosis
- A change in a lesion Size
- A change in pathology of lesion/diagnosis
- Additional need of special stains for reading a biopsy specimen
- Infection or wound complication
Will result in a change to the Good Faith Estimate
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises. or call 1-800-985-3059
