Price transparency

1. Our commitment to clear pricing

We want you to know what to expect before your visit. Our team is happy to talk with you about the expected cost of your care, check your insurance benefits, and answer billing questions at any time. Call 330-493-0009 to speak with a member of our team.

2. Your right to a Good Faith Estimate

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.

• 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.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers (opens in a new tab), email [email protected], or call 1-800-985-3059.

3. When you will receive your estimate

If you are uninsured or choose not to use your insurance (self-pay), we will give you a written Good Faith Estimate:

• Within 1 business day after scheduling, if your service is scheduled at least 3 business days in advance.
• Within 3 business days after scheduling, if your service is scheduled at least 10 business days in advance.
• Within 3 business days after you ask, if you request an estimate before scheduling.

You can receive your estimate on paper or electronically, whichever you prefer.

4. How to request an estimate

To request a Good Faith Estimate, call our office at 330-493-0009 or ask any member of our front desk team. Please let us know that you are uninsured or that you plan to pay for your care yourself.

5. What your estimate includes

Your Good Faith Estimate will list the items and services we reasonably expect to provide, along with their expected charges. Because every patient’s needs are different, your estimate is based on the information available when it is prepared. If your care plan changes, we will give you an updated estimate.

The estimate is not a contract and does not require you to receive the items or services listed.

6. If your bill is higher than your estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Please contact our office first, and we will review your bill with you. You may also use the federal patient-provider dispute resolution process. Visit www.cms.gov/nosurprises/consumers (opens in a new tab) for details, including deadlines for starting a dispute.

7. If you have insurance

If you plan to use insurance, your costs depend on your plan’s coverage, deductible, copays and coinsurance. We accept most major insurance plans and will help you check your benefits before your visit. Your insurance company can also tell you what your plan covers.

8. Self-pay rates and payment options

[Self-pay rates for our most common services are available on request. Or insert a short list of common self-pay services and prices, if the practice chooses to publish them.]

Some services, such as our complimentary consultation, have no charge.

We accept [payment methods, for example cash, check, and major credit cards]. Ask our team about [payment plans or other payment options, if offered].

9. Changes to this page

We may update this page from time to time to reflect changes in our practices or applicable law. Any changes will be posted on this page with a revised effective date.

10. Contact us

If you have questions about the cost of your care, your Good Faith Estimate, or a bill, please contact us: