​Premier Physical Therapy will provide all patients who do not have insurance or who are not using insurance with an estimate of the bill for therapy services. Please retain a copy of your “Good Faith Estimate” (GFE) quote.

 

Our initial estimate will cover the cost of the first visit, specifically for the evaluation. This estimate will be provided to you at least one (1) business day prior to the evaluation or prior to scheduling, if you prefer.

Before commencing with treatment, a second estimate will be provided to you based on the established Plan of Care. If your Plan of Care needs modification during the episode of care due to changes in your therapy needs, a new condition, or at your request, you will be informed and provided with a revised estimate, and you will have the option to continue or discontinue treatments.

 

If you receive a bill that is $400 or more than the “Good Faith Estimate,” you can dispute the bill utilizing the Patient-Provider
Dispute Resolution Process. The Selected Dispute Resolution Entities (SDR) are certified and selected by the U.S. Department of Health & Human Services (HHS). You must submit a dispute notice, the provider’s bill, and the “Good Faith Estimate” to HHS within 120 days of receiving the final bill from our practice. HHS will collect a $25 fee with your dispute resolution application.

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For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call Premier Physical Therapy at 303-412-7035.