Good Faith Estimate Policy

Effective: 10-19-2026

Last updated: October 19, 2026

COLE ALEXANDER DAOM, PLLC is committed to transparent pricing. Under federal law, patients who do not have health coverage, or who have coverage but choose not to use it, have the right to a Good Faith Estimate of their expected charges.

WHO RECEIVES A GOOD FAITH ESTIMATE

If you do not have health coverage, or you choose not to use your coverage for your care with us, we will give you a written Good Faith Estimate when you schedule a visit or when you ask for one. You may ask for an estimate before you schedule.

WHAT IT INCLUDES

Your estimate lists each service and item we expect to provide and its expected charge. Please keep it to compare with your bill.

IF YOUR BILL IS HIGHER THAN YOUR ESTIMATE

If your bill from us is at least $400 more than your Good Faith Estimate, you may dispute the bill through the federal patient-provider dispute resolution process. Disputing a bill will not affect the care you receive from us.

HOW TO ASK

To ask for a Good Faith Estimate, email contact@marysvilleacupuncture.services or call (425) 419-7033. To prepare your written estimate as federal law requires, we need your name and date of birth. We will send your estimate by email, or, if you prefer a paper copy, it will be ready within the time federal law requires, and you may schedule a time to pick it up. Pickup is by appointment only. For more information about your rights, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.