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    No Surprises Act

    Good Faith Estimate

    1224 Ocala Rd · Tallahassee, FL 32304(850) 576-2129

    Under the federal No Surprises Act, you have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services from your healthcare provider.

    Your rights

    • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
    • Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item.
    • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
    • Save a copy or picture of your Good Faith Estimate.

    What's covered

    The estimate includes related costs such as medical tests, prescription drugs, equipment, and hospital fees tied to the service.

    Learn more

    For more information about your rights under the No Surprises Act, visit cms.gov/nosurprises.

    To request a Good Faith Estimate, call University Physical Medicine at (850) 576-2129.