Good Faith Estimate

Your right to an estimate

• You may request a Good Faith Estimate before scheduling an appointment.
• If you schedule an appointment at least 3 business days in advance, Wellify Health will provide a written Good Faith Estimate within the time required by federal law.
• The estimate will describe the expected charges for the primary items or services reasonably expected as part of your care at the time it is prepared.
• The estimate is not a contract and may not include unexpected services that become necessary during treatment.

If your bill is substantially higher

If a bill from a provider or facility is at least $400 more than the Good Faith Estimate from that provider or facility, you may be able to use the federal patient-provider dispute resolution process. Keep a copy of your estimate and compare it with your bill.

Starting a dispute will not affect the quality of health care you receive. For information about your rights or the dispute process, visit CMS Medical Bill Rights or call 1-800-985-3059.

Request an estimate

To request a written Good Faith Estimate from Wellify Health, contact us before your visit: