Good Faith Estimate

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, people who do not use insurance for a visit have the right to a Good Faith Estimate of the expected charges for scheduled care. You can ask for one when you book, or before you book, and we will not charge you for it.

What We Cover in an Estimate

Your estimate lists the care we expect to provide and what we expect to charge, based on our published Fees page. It can include:

• Care packages. New patient visits, Report of Findings, re-exams, adjustments, and our ChiroPack bundles.
• Wellness and lifestyle consults. Health coaching, lab and records review, and lifestyle visits.
• Free phone consult. Our 20-minute phone consultation costs nothing and does not need an estimate.
• X-rays and outside referrals. If we recommend X-rays, imaging, lab work or care from another provider, those charges come from that provider. They are separate from our estimate, and we will tell you when we refer you so you can ask them for their own estimate.

When You Will Get It

• If you book care 10 or more business days ahead, we give you the estimate within 3 business days of booking.
• If you book 3 to 9 business days ahead, we give it to you within 1 business day.
• If you book less than 3 business days ahead, we give it to you at or before the visit, and sooner if you ask.
• If you ask for an estimate before booking, we give it to you within 3 business days of your request.

How to Ask for One

Call or text 725-250-2699, ask at the front desk, or write to 6675 S. Tenaya Way, Suite 200, Office 19, Las Vegas, NV 89113. Tell us who the patient is and what care you are considering. We provide the estimate in writing, on paper or electronically, in plain language. If you need help in another language or in an accessible format, tell us and we will arrange it.

If Your Costs Change

A new plan of care, extra visits or a service not on your estimate can change the total. We will tell you before we add it, and we will give you an updated estimate in writing.

If a Bill Is Much Higher Than Your Estimate

If you receive a bill that is $400 or more above your Good Faith Estimate, you have the right to dispute it. You must start the process within 120 calendar days of the bill, through the federal Patient-Provider Dispute Resolution process. Keep your estimate and your bill. Visit cms.gov/nosurprises or call 1-800-985-3059 to learn more. We would also like to hear from you first so we can solve it with you directly.

Your Estimate Is Not a Contract

An estimate is not a promise to deliver specific care. It is the cost we expect. You may stop or change your care at any time.

Estimate Form

Every estimate we give you includes the following:

• Patient name and date of birth
• Date the estimate was prepared
• Our name, address and contact information
• Each expected service and the charge for it
• The date range or number of visits the estimate covers
• Notice that outside providers, X-rays and labs are billed separately
• Notice of your right to dispute a bill that is $400 or more above the estimate
• A statement that the estimate is not a contract and that you may stop care at any time
• A statement that it does not include costs from other providers

Superbills and Insurance

We do not bill insurance. If you want to try for reimbursement, ask for a superbill. We cannot promise what your plan will pay.

Questions

Call or text 725-250-2699. We are glad to walk through costs with you before you decide.