According to CMS, “A good faith estimate should include expected charges for the scheduled health care items and services, including facilities fees, hospital fees, and room and board provided by the provider or facility.” A good faith estimate typically includes charges for anticipated charges from a provider and/or healthcare facility. The good faith estimate must include the list of anticipated charges in detail and must be provided to you by paper or email.
Get a “Good Faith Estimate”
The information you provide is an estimate for charges when a patient is seen at our office. All services we provide in the office are represented by a procedural code. Harmonious Living Chiropractic: Fitness & Wellness Center uses procedural codes based on the type of services provided to patients. Each code has its separate charge. Coding is determined by the government and requires a certain level of complexity. The “Good Faith Estimate” is for “self-pay” patients only. If you are using insurance (e.g. health insurance, auto insurance, workers’ compensation), view Payment Options. Below is a list of potential charges in our office.
Typical Chiropractic Codes:
- 99203: New Patient Evaluation & Management (e.g. New Patient Exam)
- 99213: Established Patient Evaluation & Management (e.g. Current/Existing Patient Re-Activation Exam or Re-Exam)
- 98940: Chiropractic Manipulative Therapy (1-2 regions) such as a chiropractic adjustment to the neck and lower back.
- 98941: Chiropractic Manipulative Therapy (3-4 regions) such as a chiropractic adjustment to the neck, mid-back, and lower back regions.
- 98943: Chiropractic Manipulative Therapy (extra-spinal region) such as chiropractic adjustment to other joints of the body (including the shoulder, hip, ankle, etc.)
For more information about the “Good Faith Estimate” contact our office.
Estimated Charges for “Self– Pay” Patients
- Harmonious Living Chiropractic: Fitness & Wellness Center is an in-network provider of ChiroHealthUSA.
- To learn how can get more affordable rates, consider joining ChiroHealth USA.
- If you are a member of ChiroHealthUSA, you can receive discount rate prices on our services; thereby reducing your overall healthcare cost at our office.
- All patients are charged our normal fees.
- The patient assumes financial responsibility for any services or procedures received in our office.