Important Notices for Therapy and Evaluation Clients
STANDARD NOTICE
“Right to Receive a Good Faith Estimate of Expected Charges” Under the No Surprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the totalexpected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call Dr. Goldsberry at (619) 738-5458.
Messaging Terms & Conditions:
You agree to receive informational messages (appointment reminders, account notifications, etc.) from Dr. Goldsberry. Message frequency varies. Message and data rates may apply. For help, reply HELP or email us at drjgoldsberry@drjgoldsberry.com. You can output at any time by replying STOP.
Mobile SMS Messaging Privacy Policy:"
Information collected:
We may collect information, such as name, phone number, and email address.
Use of information collected:
We may use the information we collect to perform the services requested including billing, customer service, appointment reminders and other administrative requests.
Sharing of information collected:
We may share information we collect with payment processors, legal authorities, partners so that these service providers can perform their normal duties. We do not share, sell, rent, or trade any information provided with third parties for promotional purposes.
As a current of prospective customer, you understand that you can text us STOP at any time to opt out of receiving SMS text messages from us. You can text us HELP at any time to receive help.
You understand that the messaging frequency may vary. Messaging & data rates may apply.
Your mobile information will not be shared with any third parties/affiliates for marketing/promotional purposes. All policies are followed as per CTIA guidelines 5.2.1. At any time if you want your information to be removed, you can contact us via our email address or regular mail.