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Your cost estimate rights

Good Faith Estimate

If you do not have insurance or do not plan to use insurance for your care, federal law gives you the right to receive an estimate of expected charges.

Last updatedSeptember 17, 2026
Review note

This is a working draft prepared for the clinic. Qualified legal and, where applicable, HIPAA compliance counsel should review it before it is treated as the clinic’s final legal notice.

Your right to an estimate

Under the No Surprises Act, health care providers and facilities generally must give uninsured and self-pay individuals a Good Faith Estimate of expected charges when care is scheduled at least three business days in advance or when an estimate is requested. You may ask for an estimate before scheduling.

What the estimate includes

The written estimate will identify the reasonably expected charges for the primary item or service and other items or services reasonably expected to be provided as part of the same period of care, based on the information known when the estimate is prepared. Ask whether any separate laboratory, pharmacy, facility, or other provider charges may apply.

A Good Faith Estimate is not a contract and does not require you to receive services. Actual charges may differ if your needs or the services provided change.

When to expect it

  • If you schedule care at least 10 business days in advance, the estimate is generally provided within 3 business days after scheduling.
  • If you schedule care 3 to 9 business days in advance, the estimate is generally provided within 1 business day after scheduling.
  • If you request an estimate without scheduling, it is generally provided within 3 business days after the request.

If the bill is substantially higher

Keep a copy of your Good Faith Estimate. If a provider or facility bills you at least $400 more than that provider or facility’s estimate, you may be eligible to use the federal patient-provider dispute resolution process. Generally, the dispute must be started within 120 calendar days of the date on the initial bill.

You may contact the provider first to ask about the difference, request that the bill be updated to match the estimate, negotiate the bill, or ask about financial assistance. Contacting the provider does not prevent you from pursuing the federal process within the applicable deadline.

Request an estimate

To request a Good Faith Estimate from Optimal Wellness Clinic, call or email us. Tell us that you are uninsured or do not intend to submit the care to insurance and describe the service you are considering. An estimate does not affect your right to choose whether to proceed.

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