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Good Faith Estimate

Good Faith Estimates for Self-Pay

Atlanta Gynecology and Obstetrics, AGO, is legally required to provide patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services based on information known at the time. This estimate will assist in explaining how much your medical care is anticipated to cost.

Please note that a good faith estimate is an estimate based on information known at the time with respect to anticipated non-emergency items/services. The good faith estimate is not a guarantee that your final costs will match the estimate. This means that the final cost of services may be different than this estimate. Final costs for which you are billed may vary for many reasons, among them are the patient’s medical condition, unknown circumstances or complications, final diagnosis, and recommended treatment ordered by the physician.

  • You have the right to receive a good faith estimate for the total expected cost of non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • You can request a good faith estimate at any time by contacting the office via email at billing@atlantagynob.com or call our Decatur Office at (404) 299-9724 or Lilburn Office at (770) 923-5033.
  • Different time frames apply with respect to providing you a good faith estimate depending on when/how far in advance your non-emergency care is scheduled.  AGO endeavors to provide all estimates as soon as practicable.
  • 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, call our Decatur Office at (404) 299-9724 or Lilburn Office at (770) 923-5033.  You can also obtain information at https://www.cms.gov/nosurprises.

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