Your Right to a Good Faith Estimate
Effective Date: July 21, 2026
Under federal law, healthcare providers generally must give patients who do not have insurance or who choose not to use insurance an estimate of the expected cost of scheduled, nonemergency care.
You Have the Right to a Written Estimate
If you are uninsured or will not submit a claim to insurance for your care, you may ask Le Dental Care for a written Good Faith Estimate before scheduling. You may also be entitled to an estimate after scheduling qualifying care.
A Good Faith Estimate explains the reasonably expected charges for the primary items or services to be provided by Le Dental Care. Care from another provider or facility may require a separate estimate.
When You Should Receive It
- If care is scheduled 3 to 9 business days in advance, the estimate generally must be provided within 1 business day after scheduling.
- If care is scheduled 10 or more business days in advance, the estimate generally must be provided within 3 business days after scheduling.
- If you request an estimate before scheduling, it generally must be provided within 3 business days after the request.
You may request an estimate even when these timing rules do not require an automatic estimate.
The Estimate Is Not a Contract
The estimate is based on information known when it is prepared. Your dentist may recommend different or additional care after an examination, diagnostic imaging, consultation, or an unexpected clinical finding. The estimate may not include separately scheduled care or services provided by another provider or facility.
Ask questions if you do not understand the estimate. Keep a copy and compare it with your final bill.
If Your Bill Is Substantially Higher
If a final bill from a provider is at least $400 more than that provider’s Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process. Starting a dispute does not guarantee that the bill will be reduced.
For federal information about Good Faith Estimates and billing disputes, visit:
- https://www.cms.gov/nosurprises/consumers
- https://www.cms.gov/medical-bill-rights
- Call 1-800-985-3059.
Do not include protected health information in an ordinary email to a government agency unless instructed to use a secure method.
Request an Estimate
To request a Good Faith Estimate, contact the office where you expect to receive care:
Stockton Office
5405 North Pershing Avenue, Suite 20
Stockton, CA 95207
(209) 851-2171
Elk Grove Office
9575 Laguna Springs Drive, Suite 102
Elk Grove, CA 95758
(916) 691-1141
This notice summarizes certain federal rights and does not replace the official estimate, billing statement, insurance explanation of benefits, or applicable law.