Your Right to a Good Faith Estimate

Bridgeway Health PLLC | Uninsured and self-pay care

You have the right to receive a Good Faith Estimate explaining how much your health care is expected to cost. If you do not have health insurance, or you choose not to use it for a service, health care providers generally must give you an estimate of expected charges for non-emergency care. You can ask for an estimate before you schedule a service.

Ask before care is scheduled

Call Bridgeway Health at (606) 202-7654 or contact billing@bridgewayhealthky.com. Tell us whether you will use insurance. We will explain which providers/services are included and provide the estimate in writing, on paper or electronically as you prefer. Free language assistance and appropriate disability communication aids are available.

For care scheduled 3–9 business days ahead, the estimate is due within one business day after scheduling. For care scheduled at least 10 business days ahead, it is due within three business days after scheduling. If you request an estimate without scheduling, it is due within three business days of the request. Business days exclude weekends and federal holidays. For care scheduled less than three business days ahead, the federal advance-estimate timing requirement does not apply; you may still ask about costs.

Keep your estimate and compare the bill

An estimate is not a bill or a requirement to receive treatment. Actual charges can differ when additional care is needed. Ask your provider about an unexpected bill. If a provider’s bill is at least $400 above that provider’s estimate and the federal requirements are met, you may qualify for the patient-provider dispute process. Start within 120 calendar days after receiving the initial bill. A voluntary estimate for care scheduled less than three business days ahead does not make that care eligible for this federal dispute process.

For questions about this right or the federal dispute process, visit www.cms.gov/nosurprises or call 1-800-985-3059. Keep a copy or photo of your estimate and bill. These rights are not waived by signing a clinic financial policy.

Bridgeway Health PLLC | 1007 Cumberland Falls Hwy, Suite 3, Corbin, KY 40701
Phone: (606) 202-7654 | Public fax: (606) 262-7903