You have the right to receive a Good Faith Estimate of expected charges if you do not have qualifying health insurance or you are not using insurance to pay for scheduled or requested non-emergency healthcare.
You may request a written estimate even if you have not scheduled care. If care is scheduled 3–9 business days in advance, the estimate generally must be provided within 1 business day after scheduling. If care is scheduled at least 10 business days in advance, the estimate generally must be provided within 3 business days after scheduling. If requested without scheduling, the estimate generally must be provided within 3 business days of the request.
An estimate generally identifies reasonably expected items, services, diagnostic or service codes when applicable, expected charges, and provider information. Estimates currently generally cover the estimating provider or facility; other providers may issue separate estimates. Actual charges can differ when unforeseen care becomes necessary. An estimate is not a bill.
If a bill from a provider or facility is at least $400 more than its estimate, you may qualify for the federal patient-provider dispute resolution process. Generally, initiate the dispute within 120 calendar days after receiving the initial bill. You may contact the Clinic with billing questions before or during a dispute.
To request a Good Faith Estimate: Call 870-792-8825 and ask for Billing and Patient Services. Please identify the service you are considering and your preferred safe delivery method. Do not send medical or payment information through ordinary email.
For federal guidance or dispute assistance: https://www.cms.gov/medical-bill-rights or 1-800-985-3059.