No Surprises Act

“Right to Receive a Good Faith Estimate of Expected Charges” Under the No Surprises Act

You Have the Right to Receive a Good Faith Estimate of Expected Charges Under the No Surprises Act
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost for any non-emergency items or services. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

If you are a self-pay patient, we will provide you with a Good Faith Estimate in writing through the patient portal at least 1 business day prior to your appointment. You can also call us at 732-723-7130 or email us at to request self-pay rates before you schedule an appointment.

If you receive a bill that is $400 or more than your Good Faith Estimate per date of service, you can dispute the bill. Email us at [email protected] with a copy or picture of the Good Faith Estimate and your bill from us for prompt resolution.
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, visit The New Jersey Department of Banking & Insurance at 609-292-7272 or visit “Out-of-network Consumer Protections” for more information about your rights under New Jersey law. Good Faith Estimate.