GOOD FAITH ESTIMATE

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, Schmidt Chiropractic gives patients who don’t have insurance, or who are choosing not to use their insurance, an estimate of their bill for services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs such as exams, treatments and therapies.
We will give you a Good Faith Estimate over the phone when you make your appointment, and we will have that same Good Faith Estimate for you when you arrive to your appointment. We are generally able to get patients in for appointments the same day or within one business day of the appointment request, however if your appointment is scheduled further out you do have the right to ask that the Good Faith Estimate be mailed to you.
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, visit www.cms.gov/nosurprises. You can also call our office at 913-897-2111 and speak with Tara.

Adam Ludwin, D.C.,CCSP

8310 W. 151st St • Overland Park, KS • 66223

NPI: 1073198313 - TIN: 84-3874057

Schmidt Chiropractic

Schmidt Chiropractic

GOOD FAITH ESTIMATE

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