Providers are required to provide uninsured and self-pay patients with Good Faith Estimates of expected charges for all scheduled services and items before care and upon request when shopping for care. The Good Faith Estimates show the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur.
Make sure to save a copy or picture of your Good Faith Estimate.
If you receive a bill that is at your Good Faith Estimate, you can dispute the bill.
If the charges are higher than the Good Faith Estimate, you may contact STEELE CREEK SMILES at (704) 587-1010 and resolve the issue, or you may start a dispute resolution process. If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a use of the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit https://www.cms.gov/nosurprises/consumers or call 1- 704-587-1010.
