Welcome Brochure

GOOD FAITH ESTIMATES If you are uninsured or prefer to pay directly out of pocket, you have the right to receive a Good Faith Estimate explaining how much your medical care will cost. Please note this at the time of scheduling your appointment to ensure we can prepare the information in advance for your review. Under the law, healthcare organizations need to give patients who don’t have insurance or who are not using insurance, an estimate of the total expected cost for non-emergency medical items and services. This included related costs like medical tests, prescription drugs, and equipment. What you need to know: • Make sure your healthcare organization gives you a Good Faith Estimate in writing or at least 1 business day before your appointment. You can also ask your healthcare organization, and any other organization you choose, for a Good Faith Estimate before you schedule the service, or an item is ordered. • If you have a question about your Good Faith Estimate or your bill, please speak with a representative in the Patient Financial Services department at (866) 905-4477. • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute your bill. • Make sure to save a copy or picture of your Good Faith Estimate. • For questions or more information about your Good Faith Estimate, visit cms.gov/nosurprises or call (800) 985-3059. We accept cash, checks, money order, American Express, Discover, Visa, and MasterCard including contactless payment methods. You can pay your bill online through your patient portal account, in person at the University Eye Center or by mail. Forms of Payment If you have questions or need assistance with your bill, our Patient Financial Services Representatives may assist you with information, payment arrangements, and insurance billing problem resolution. Contact patient Financial Services at (866) 905-4477, Monday through Friday, 8:30 am – 5:00 pm. Billing Questions & Assistance

UNIVERSITYEYECENTER.ORG 7