Right to Receive a Good Faith Estimate of Expected Charges

Responder First Wellness Medical Corporation

You have the right to receive a “Good Faith Estimate” explaining how much your care will cost.

Under federal law, health care providers must give patients who do not have insurance, or who are not using insurance for a service, an estimate of the expected cost of their care before that care is provided.

• 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 provider gives you a Good Faith Estimate in writing at least 1 business day before your 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.

To request a Good Faith Estimate, contact Responder First Wellness at (530) 625-7738.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.