Good Faith Estimate and No Surprises Act

FINANCIAL RESPONSIBILITY

No one likes to be surprised by the cost of their medical care. That’s why it’s important to understand the insurance you carry, along with other health care accounts, to determine what your financial responsibility is for your medical care.

We are committed to sharing information in ways that will help you make informed decisions about health care services.

GOOD FAITH ESTIMATE

As of January 1, 2022, you have the right to receive a Good Faith Estimate explaining how much your medical care will cost if you are uninsured or are electing to pay for care without insurance. A Good Faith Estimate will include related costs like medical tests, prescription medications, equipment, and hospital fees.

As a patient, you have rights. Upon receiving your bill, if the total costs exceeds $400 from the Good Faith Estimate, you can dispute the bill. It is important that you save a copy or picture of your Good Faith Estimate for disputing purposes.

For questions or more information about your right to a Good Faith Estimate visit www.cms.gov/nosurprises.

SURPRISE BILLING

“Surprise billing” is an unexpected bill. This can happen when you see a provider that is out-of-network with your insurance, but the facility your care is received from is in-network. Learn more about surprise billing here.

Pricing Questions

The Orthopaedic & Fracture Clinic, P.A. is committed to providing the best care and services. If you have specific questions about your insurance coverage and financial responsibility, please contact us at 507.386.6603.

Good Faith Estimate (PDF)

No Surprises Act (PDF)

The latest version of Adobe Acrobat Reader is required to view and print PDF files, and it is available here.