Good Faith Estimates - Asante

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Good Faith Estimates

Patients who don't have insurance or who are not using insurance have the right to receive a "Good Faith Estimate" explaining how much their medical care will cost.

Call us to receive an estimate

  • Hospital: 541-789-8723 option 1.
  • Clinic: 541-789-8723 option 2.

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost

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.

  • 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 medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • 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 www.cms.gov/nosurprises.


Language assistance services

If you speak another language, language assistance services, free of charge, are available to you. Call 541-789-5322; TTY: 541-789-7104. 

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 541-789-5322 (TTY: 541-789-7104).

Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 541-789-5322 (TTY: 541-789-7104).

Chinese: 注意:如果您使用繁體中文, 您可以免費獲得語言援助服務. 請致電 541-789-5322 (TTY: 541-789-7104).

Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 541-789-5322 (телетайп: 541-789-7104).

Korean: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 541-789-5322 (TTY: 541-789-7104) 번으로 전화해 주십시오.

Ukrainian: УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером 541-789-5322 (телетайп: 541-789-7104).

Japanese: 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます 541-789-5322 (TTY:541-789-7104)まで、お電話にてご連絡ください.

Arabic:

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 5417895322
(TTY: 541-789-7104) :رقم هاتف الصم والبكم

Romanian: ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la 541-789-5322 (TTY: 541-789-7104).

Mon-Khmer, Cambodian: ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ 541-789-5322 (TTY: 541-789-7104)។

Cushite (Oromo): XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 541-789-5322 (TTY: 541-789-7104).

German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 541-789-5322 (TTY: 541-789-7104).

Persian (Farsi):

توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با
.تماس بگیرید (TTY: 541-789-7104) 541-789-5322 

French: ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 541-789-5322 (ATS: 541-789-7104).

Thai: เรียน: ถ้าคณพดภาษาไทยคณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 541-789-5322 (TTY: 541-789-7104)