Your Right to a Good Faith Estimate

Last updated: June 2026

Under the federal No Surprises Act, you have the right to receive a Good Faith Estimate explaining how much your medical care will cost.

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 exams, treatment, and any other services Top Spine Chiropractic & Wellness provides. If you are uninsured, or you are not planning to submit a claim to insurance for your care, Top Spine Chiropractic & Wellness is required to give you a Good Faith Estimate of expected charges before you schedule a service — or any time you ask for one.

What the estimate includes

• The expected charges for the services or items you are scheduling or asking about;
• Related services reasonably expected to be provided together with the primary service;
• A clear, itemized list so you can plan ahead.

How to get one

You can ask Top Spine Chiropractic & Wellness for a Good Faith Estimate before you schedule a service, or at any time. Just contact our office at (774) 280-4790. We will provide a written estimate within the timeframe required by law — within 1 business day if your service is scheduled at least 3 business days out, or within 3 business days of your request.

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 have the right to dispute the bill through the federal patient-provider dispute resolution process. You can start a dispute within 120 calendar days of the date on your bill.

Good to know

• A Good Faith Estimate is an estimate of expected charges — it is not a bill, and your actual charges may be lower or higher.
• Receiving a Good Faith Estimate does not obligate you to receive the services.
• Keep a copy of your Good Faith Estimate in a safe place.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.