At Maxcare Clinic, your peace of mind and financial clarity are part of our commitment to quality care. In compliance with the No Surprises Act effective January 1, 2022, and broader healthcare transparency regulations, we want you to know your rights and protections when it comes to medical billing and costs.

🏥 Your Right to a Good Faith Estimate

If you are uninsured or choosing not to use your insurance, you have the right to request and receive a Good Faith Estimate of expected charges for medical items and services. This estimate includes:

• All services scheduled in advance (e.g., exams, procedures, labs)
• Related costs such as diagnostics or prescriptions
• Expected fees from all participating providers involved in your care

You can request a Good Faith Estimate:

• Before you schedule an appointment
• At any time in your care planning process
• By contacting us at (912) 297-9003 or info@usa.maxcareclinic.com

💡 What the No Surprises Act Protects You From

You are protected from surprise medical bills if you:

• Receive emergency care from an out-of-network provider or facility
• Are treated by an out-of-network provider at an in-network hospital or surgical center
• Do not knowingly consent to being treated by an out-of-network provider

These protections apply to most commercial and employer-based health plans. You won’t be charged more than your in-network copay, coinsurance, or deductible under these circumstances.

📋 Dispute Rights

If you receive a bill $400 or more over your Good Faith Estimate, you can dispute the charges through the U.S. Department of Health & Human Services (HHS).

Learn more about your rights or start a dispute by visiting:
🔗 www.cms.gov/nosurprises
📞 Call: 1-800-985-3059

📌 Our Promise to You

Maxcare Clinic believes healthcare should never come with financial surprises. We strive to:

• Maintain transparent pricing
• Offer upfront estimates
• Answer all your billing questions with honesty and accuracy

For help with understanding your estimate or any billing matter, contact our patient services team at (912) 297-9003 or billing@usa.maxcareclinic.com.