Notice of Your Rights Under the No Surprises Act

Della Logan, SLP

9008 Elk Grove Blvd; Elk Grove, CA 95624

Phone: (916) 491-0688 • Fax: (916) 252-3646

della@loganslp.com

www.loganslp.com

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.  

Della Logan SLP will provide you a Good Faith Estimate upon request and when you schedule your first visit and are not using health insurance to pay for services.

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.

• 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, equipment, and outpatient office 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.

For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises or contact us at the above listed contact information.