GOOD FAITH ESTIMATE
YOUR RIGHT TO TRANSPARENT PRICING
UNDERSTANDING YOUR RIGHT
If you are uninsured or choose not to use insurance, federal law lets you request a written “Good Faith Estimate” (GFE) of the expected charges for non-emergency care.
We’re happy to give you a clear, upfront cost breakdown for any of our services—just ask.
AlignSD Wellness Center
A. Your Rights
You can receive a Good Faith Estimate for the total expected cost of services we provide—such as examinations, chiropractic adjustments, soft-tissue therapy, or other in-office treatments.
Transparent Pricing
We disclose fees in advance so you can decide whether to proceed with care.
Itemized Details
Each estimate lists anticipated charges for every service we expect to perform.
B. How to Get an Estimate
Ask for a written Good Faith Estimate at least one (1) business day before your scheduled visit—or any time you are comparison shopping.
Request Options
Call, email, or stop by our front desk. We aim to provide the estimate within one business day of your request.
What You’ll Receive
A dated, written statement outlining the services and their associated costs that we reasonably expect based on your treatment plan.
C. If Your Bill Is Higher
If the final bill is $400 or more above your Good Faith Estimate, you may start a “patient–provider dispute resolution” process.
Keep Your Estimate
Save a copy of your GFE—it is required documentation for any dispute.
Dispute Timeline
You must begin the dispute within 120 days of receiving the bill that exceeds your estimate.
D. Need More Info?
Visit www.cms.gov/nosurprises for federal resources, or contact us directly with any questions about pricing or billing.