Good Faith Estimate

‘Self-pay’ patients have the right to receive a Good Faith Estimate explaining how much your medical care will cost before starting services with us.

In July 2021, the U.S. Departments of Health and Human Services, Labor, and the Treasury (the Departments) released the “Requirements Related to Surprise Billing; Part I.” This law restricted surprise billing for patients in job-based and individual health plans.

• Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
• You have the right to receive a GFE for the total expected cost of any non-emergency items or services. Your GFE will include related costs like medical tests, examinations, office visits and prescription drugs.
• Make sure your health care provider gives you a GFE in writing at least 1 business day before your medical service or item. Additionally, you can also ask your health care provider for an estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your GFE, you can dispute the bill.
• Finally, make sure to save a copy or picture of your Good Faith Estimate.

If you have any questions or would like more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our office at 510-843-2220.

Also, if you are interested in becoming a new patient, please complete our New Patient Form. Please inform the staff if you are a self-pay patient, so we can assure you get the information you need about cost of treatment.