You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under Federal law, all health care providers need to give patients who don’t have insurance, or who are not using their insurance an estimate of the bill for medical items and 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 like medical tests, prescription drugs, equipment and hospital fees.
- Make sure your health care providers give you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- 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 or call 1-800-985-3059.
What are my Rights?
- I am not obligated to receive services from Therapeutic Oasis or any out-of-network provider.
- I can cancel services at any time by notifying the front desk staff 48 business hours before the scheduled service date.
- I have a right to initiate a dispute resolution process if the actual billed charges are substantially in excess of the expected charges included in this Good Faith Estimate.
- I may contact the Office Manager to let them know the billed charges are higher than the Good Faith Estimate. I can ask them to update the bill to match the Good Faith Estimate, negotiate the bill or ask if there is financial assistance available.
- I may start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). I understand that the dispute process must begin within 120 calendar days from the date of the original bill.
- There is a $25 fee to use the dispute process. If the agency reviewing my dispute agrees with me, I will have to pay the price on the Good Faith Estimate. If the agency disagrees with me, I will pay the higher amount.
- I can contact the No Surprises Help Desk at 1-800-985-3059 (or www.cms.gov/nosurprises) at any time to start the dispute process or get more information.
Therapeutic Oasis does not participate in any health insurance plans. That means we do not have any agreement or arrangement with health insurance companies regarding the fees we charge our clients. Therapeutic Oasis has always been transparent in the fees we charge for our services, and will continue to do so. All clients will receive a Good Faith Estimate prior to scheduling their first appointment, and when requested at any time after services begin. Please see our Fee Schedule under Client Information for fee information about our services.
What else do I need to know?
- Therapeutic Oasis is not in-network with any insurance company and clients are responsible for payment in full regardless of how much, or if, their insurance company provides benefits for services.
- Information provided in a Good Faith Estimate is only an estimate of services reasonably expected to be furnished at the time the Estimate was prepared. Actual items, services or charges may differ from the Estimate.
- Additional services may be recommended as a part of the course of care that must be scheduled or requested separately and are not reflected in the Good Faith Estimate.
- The Good Faith Estimate is not a contract.