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The short version

If you are paying for your own care because you don't have health insurance or aren't using it, you can ask us for a written estimate of the expected charges before your visit. This is called a Good Faith Estimate, and a federal law called the No Surprises Act gives you the right to receive one.

Who this applies to

This notice applies to patients who:

  • don't have health insurance, or
  • have insurance but choose not to use it for a visit (sometimes called self-pay).

If you are using your insurance, see our insurance and billing page, and call us to check your benefits before your visit.

How to ask for an estimate

Call the office at (513) 860-4600 before your visit. Tell us you don't have insurance or aren't using it, and ask for a Good Faith Estimate. According to the Centers for Medicare & Medicaid Services (CMS), you should receive an estimate when you schedule care at least 3 business days ahead, or when you ask for one. An estimate isn't provided for emergency care.

An estimate covers the care you and your provider plan ahead of time. Care that comes up during your visit and wasn't planned may not be included. If other providers or facilities are part of your care, such as an outside lab, ask each of them for their own estimate.

The official notice

Your Right to Receive a Good Faith Estimate of Expected Charges

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

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • 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 medical 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.

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

Learn more

CMS explains your rights under the No Surprises Act at cms.gov/nosurprises, including a page on your rights when you're not using insurance.

Questions about this page? Call the office at (513) 860-4600.

Related care

Insurance and billing

How we bill insurance for primary care and cognitive decline care, and who to call with billing questions.

Learn more

New patients

We are accepting new patients. Call (513) 860-4600. Here is what to have ready and what to bring.

Learn more

Contact and directions

Phone, fax, hours and directions to our office on Wunnenberg Way in West Chester Township.

Learn more

Good to know

Frequently asked questions

Patients who don't have health insurance, or who have insurance but aren't using it for their care, can ask for a Good Faith Estimate. Call (513) 860-4600 before your visit.

Call us before your visit and we'll help you check your benefits. Your plan decides what it pays, so you may also want to call the member services number on your insurance card.

Ready to talk with us?

Call our front desk at (513) 860-4600. We're open Monday–Friday, 7:30 AM – 4:30 PM. For a life-threatening emergency, call 911.

Mon–Fri, 7:30 AM–4:30 PMOpen nowClosed now4870 Wunnenberg Way, West Chester, OH

Call (513) 860-4600

Mon–Fri, 7:30 AM–4:30 PMOpen nowClosed now