Good Faith Estimate Notice
Your Right to Receive a Good Faith Estimate
You have the right to receive a Good Faith Estimate explaining how much your health care services are expected to cost.
Under federal law, health care providers are required to provide uninsured or self-pay patients with an estimate of expected charges for scheduled or requested non-emergency health care services.
This notice applies to patients who do not have health insurance, as well as patients who have health insurance but choose not to use it for services at Chiropractic Express.
Good Faith Estimates at Chiropractic Express
Chiropractic Express is a cash-based chiropractic office with clear pricing for visits, packages, and wellness care. Our current pricing is listed on this website and is available in the office.
A Good Faith Estimate may include the expected cost of chiropractic services that are reasonably expected at the time the estimate is created. This may include services such as an initial visit, follow-up visits, chiropractic adjustments, supportive therapies, or other services discussed as part of your care.
Patients may request a written Good Faith Estimate before receiving services. If services are scheduled in advance, a Good Faith Estimate will be provided when required. Walk-in patients may also ask about expected costs before receiving care.
Important Disclaimer
A Good Faith Estimate is not a contract and does not require you to receive services from Chiropractic Express.
The estimate is based on information available at the time it is created. Actual services and charges may vary depending on your condition, exam findings, treatment needs, clinical recommendations, and the services you choose to receive.
If additional services are recommended or requested that were not included in the original estimate, the total cost may be different. Chiropractic Express encourages patients to ask questions about pricing before receiving care.
If Your Bill Is Higher Than Your Good Faith Estimate
If you receive a bill that is at least $400 more than your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process.
You may contact Chiropractic Express first to let us know that the billed charges are higher than the Good Faith Estimate. You may ask questions about the bill, request clarification, or ask whether the bill can be reviewed.
You may also have the right to start a dispute resolution process through the U.S. Department of Health and Human Services. If you choose to use the dispute resolution process, you must generally start the process within 120 calendar days of the date on the original bill.
Questions or Requests
To request a Good Faith Estimate or ask questions about pricing, please contact:
Chiropractic Express
2886 Tamiami Trail, Suite 6
Port Charlotte, FL 33952
Phone: (941) 249-9020
Email: ChiropracticExpress@gmail.com