Good Faith Estimate

You have the right to know the expected cost of your care.

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Under federal law, individuals who do not have health insurance or who choose not to use their health insurance to pay for health care services generally have the right to receive a Good Faith Estimate of the expected cost of their care.

 

If you schedule services with AGUAS at least three (3) business days in advance, or if you request an estimate before scheduling services, AGUAS will provide a written Good Faith Estimate as required by applicable federal law.

 

The Good Faith Estimate will describe the services reasonably expected to be provided and the anticipated charges for those services. It is an estimate based on the information known at the time and is not a contract.

 

It does not require you to receive services from AGUAS.

 

The actual services you receive, the number or frequency of sessions, or your total cost of care may change if your needs or treatment plan change.

 

If a bill from a provider is at least $400 more than the Good Faith Estimate from that provider, you may be eligible to use the federal patient-provider dispute resolution process.

 

Please keep a copy of your Good Faith Estimate for your records and compare it with any bills you receive.

 

Questions about your estimated cost of services?

 

Contact AGUAS at 540-372-7211.

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For additional information about your rights under the No Surprises Act and Good Faith Estimates, visit the Centers for Medicare & Medicaid Services (CMS).

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