No Surprises Act
Your right to a Good Faith Estimate
If you are uninsured or not using insurance, you have the right to know what your care will cost — in writing, before it starts.
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.
Your right to a Good Faith Estimate
- You have the right to receive a Good Faith Estimate for the total expected 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 1 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.
How to get one from us
If you do not have insurance, or you have insurance but choose not to use it for your wound care, call us at (201) 773-0909 and we will provide a written Good Faith Estimate before your first visit. There is no charge for the estimate, and asking for one will not affect your care.
If you are using Medicare or another health plan
This notice applies to patients who are uninsured or self-paying. If you are using Medicare, Medicaid, or another health plan, we verify your benefits before care begins and go over any expected deductible or coinsurance with you at that time.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.
How to reach us
Privacy Officer (Dr. Frank Colabella), Crosstown Mobile Wound Care New Jersey
Phone: (201) 773-0909
Address: 23-00 State Route 208, Fair Lawn, NJ 07410
Serving the greater North & Central Jersey area, New Jersey