Compliance

Good Faith Estimate

Under the federal No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost if you are uninsured or plan to self-pay.

What a Good Faith Estimate covers

The estimate shows the expected costs of medical items or services related to your surgical care at Downey Outpatient Surgery Center, including the facility fee, anesthesia, and related services we can reasonably anticipate.

How to request one

You can request a Good Faith Estimate before scheduling or at any point during your care. We are required to provide one at least 1 business day before a scheduled service if requested, or within 3 business days of a general request.

Request by email: [email protected] · By phone: (562) 555-0100

If you are billed more than your estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill through the Federal Patient-Provider Dispute Resolution process.

For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

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