Rose City Physical Therapy

Good Faith Estimate for Cash-Based Services

Good Faith Estimate for Cash-Based Services

Rose City Physical Therapy

Effective Date: January 1, 2025

What Is a Good Faith Estimate?

A Good Faith Estimate (GFE) outlines the anticipated costs for your self-pay physical therapy services. This estimate is required by the federal No Surprises Act, which aims to ensure transparency in healthcare pricing. It provides you with an upfront understanding of the expected charges based on the information available at the time the estimate is prepared.

Why Is a Good Faith Estimate Required?

The No Surprises Act mandates that healthcare providers give patients clear cost estimates for services to help avoid unexpected bills. At Rose City Physical Therapy, we are committed to complying with this law and providing you with the financial clarity you need for your care.

How Does It Work?

  • Scheduling Services: When you schedule self-pay physical therapy services, we will provide you with a verbal summary of the cost for the initial evaluation and follow-up visits.
  • Written Estimate: A written Good Faith Estimate will be provided during your initial evaluation, outlining the likely duration (30 minutes or 1 hour), frequency, and number of follow-up visits based on your treatment plan and progress.

Additional Information:

  • The costs included in the Good Faith Estimate are estimates and may change if your treatment plan requires additional or fewer services.
  • If your health needs change, or you request additional services, a revised Good Faith Estimate may be issued.

Important Disclaimer:

  • The Good Faith Estimate is not a contract and does not guarantee final charges. Actual costs may vary based on your clinical needs.
  • If you are billed for an amount that exceeds the estimate by $400 or more, you have the right to dispute the bill.
  • For further details about your rights under the No Surprises Act, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Rose City Physical Therapy is committed to providing transparent and patient-focused care while helping you understand your financial responsibilities.