Your right to a good faith estimate

Who has this right?

You do, if you are uninsured, or if you are insured and you tell us you are not going to file a claim for this care. Federal law calls that being a self-pay patient. You do not have to explain why, and asking for an estimate does not commit you to booking anything.

If you are using insurance, this particular right does not apply to you, because your plan and your benefits decide what you pay. Call us anyway and we will tell you what we know about how your plan handles the visit.

How do you ask for one?

Call (817) 382-6789 and say you would like a good faith estimate. You can ask before you book anything, and you can ask again if what you need changes. You can also ask us at the front desk of either office, and you can ask during the call when you schedule.

We will ask you what care you are asking about, so tell us as much as you know: the office you would be seen at, whether it is a first visit or a follow-up, and whether a procedure has been discussed. The more specific the question, the more specific the estimate.

When do we have to give it to you?

The deadlines are set by federal law and they run in business days:

• If you schedule care that is 3 to 9 business days away, we give you the estimate within 1 business day of scheduling it.
• If you schedule care that is 10 or more business days away, we give you the estimate within 3 business days of scheduling it.
• If you just ask, without scheduling anything, we give you the estimate within 3 business days of the request.

If your care is scheduled fewer than 3 business days out, no estimate is required. We will still tell you what we can, but an estimate given in that window is a voluntary one and it does not carry the dispute rights described below.

What will the estimate include, and what will it not?

The estimate covers the items and services we expect to provide: the visit itself, and any procedure Dr. Knight expects to perform, with the codes and the charges written out.

It does not cover charges from other providers involved in the same care. If you need surgery, the hospital, the anesthesia team and the pathology laboratory each bill you separately and each sets its own charges. Federal enforcement of the co-provider part of this rule is currently suspended, so our estimate is ours alone. Ask each of those providers for their own estimate, and call us if you are not sure who they are.

An estimate is our honest expectation of the cost of the care we describe. It is not a bill and it is not a quote you are locked into. If what you need turns out to be different, the cost will be different, and we will tell you.

What if the bill comes in higher than the estimate?

If the final bill is at least $400 more than the good faith estimate we gave you, federal law lets you dispute it. You have 120 calendar days from the date on the bill to start that process with the U.S. Department of Health and Human Services. The steps are published at cms.gov/nosurprises, and you can call 1-800-985-3059 to ask about them.

Call us first if you can. Most gaps of that kind are a coding question or a service that was added on the day, and we would rather explain the bill than have you dispute one you did not need to.

Does Texas give you anything more?

Yes, and it is broader than the federal right. Under Texas law, if you ask us for an estimate because you are uninsured or because you are seeking care from us out of network, we give you one within 10 business days of your request. That covers insured patients who are out of network, who are not self-pay patients under the federal rule.

Texas also gives you the right to an itemised statement of what you were billed for, within 10 business days of asking for it. Call (817) 382-6789 and ask.

Keep the estimate

Save a copy of any estimate we give you. You will need it if you ever want to compare it against a bill, and it is the document the dispute process is built around.

Where these rules come from

Federal good faith estimate requirement: 45 CFR 149.610. Dispute threshold and the 120 day window: 45 CFR 149.620. Texas estimate and itemised statement rights: Tex. Occ. Code §101.352. This page is a notice of your rights and of how to use them with us. It is not legal advice, and it is not a price list. Nothing on this page is a quote.