Patient Estimates

Disclaimer

What you should know about your estimate: This notice is not a guarantee of the total charges that may be billed, the amount covered by your insurance plan, or the amount you may be responsible for. Financial Assistance plans may or may not be calculated into this good faith estimate. We cannot always determine the exact amount you may owe until the service is completed and charges for any procedures, tests, imaging services, supplies, and medications are added to your account. After insurance is billed, your benefits will ultimately determine the amount you owe (including deductibles, co-pay, co-insurance, and out-of-pocket maximums). Depending on outstanding claims and/or network benefits, the remaining balance may be higher or lower than the estimate provided. After we receive the insurance payment we will deduct your deposit from the remaining balance. Any additional balance still owed will be patient responsibility. This estimate does not include charges from any independent contractors. Additional imaging or specialty charges may or may not be calculated at the time the good faith estimate is created. You may receive separate statements from surgeons, anesthesiologists, radiologists, and other physicians for other services not billed by Samaritan Health Services. Questions or assistance regarding their billing processes should be directed to their offices.

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