Federal Patient Protection
Good Faith Estimate · No Surprises Act
Federal law requires that you receive a Good Faith Estimate of expected charges for services you schedule at PSEC. This applies to self-pay patients and patients whose services are not billed to insurance.
What Is a Good Faith Estimate?
The Good Faith Estimate gives you an itemized list of expected charges for the eye care services you are scheduling. It is not a final bill but a reasonable estimate based on the information available at the time you schedule.
When You Receive a Good Faith Estimate
- Scheduled services 3+ business days in advance: GFE provided within 1 business day of scheduling
- Scheduled services 10+ business days in advance: GFE provided within 3 business days of scheduling
- Upon your request at any time
What's Included in Your Good Faith Estimate
- Description of services scheduled (comprehensive exam, specialty consult, IPL therapy, etc.)
- Provider name and contact information
- Diagnosis codes (when applicable)
- Service codes (CPT)
- Expected charges per service
- Total estimated charges
Your Right to Dispute
If your final bill is at least $400 more than your Good Faith Estimate, you may dispute the bill through the federal Patient-Provider Dispute Resolution (PPDR) process.
To initiate a dispute: www.cms.gov/nosurprises or call 1-800-985-3059
Request Your Estimate
To request a Good Faith Estimate before any scheduled service:
- Email: estimates@pugetsoundeyecare.com
- Call: (206) 526-5222 (Wallingford) or (425) 454-0230 (Bellevue)
- In person: Ask the front desk at check-in
Important note: The Good Faith Estimate is for self-pay patients only. If your insurance is being billed, the actual amount you owe will depend on your specific plan benefits, deductible, copay, and coinsurance. We provide insurance verification as a courtesy before specialty services.