Good Faith Estimate Rights for our Patients

Notice of Patient Protections - Good-Faith Estimate of Expected Charges

Notice of Patient Protections – Good-Faith Estimate of Expected Charges

First, you may call and request a meeting with one of our pain health coaches to guide you. The Minnesota Head & Neck Pain Clinic wants to do our part to protect our patients from surprise bills. While we wait for many details regarding the compliance of the No Surprises Act, we assure you of our commitment to comply with all guidelines to protect our patient’s rights and will update this page as further information emerges.

If You Have Insurance

Your health plan can give you the most accurate price for medical services.

Minnesota law requires physicians, hospitals, and health plans to provide consumers with a good faith estimate of the cost of their care. Over 94 percent of Minnesotans have insurance, and that number is expected to increase as the Affordable Care Act is fully implemented. Because health insurers negotiate different payment rates for services with each health care provider, including hospitals, physicians, and clinics, the best way to compare prices you will pay is to contact your own insurance company. Your final out-of-pocket costs can be higher or lower than your neighbor’s — even when you’ve undergone the same procedure. That’s because health insurance plan payments vary, and insurance plan benefit levels are unique to each plan – insurance companies sell policies with different levels of benefits to different employers and through MNsure, the state’s health insurance exchange. Other factors that impact price may be complications or other health conditions you may have. Your insurance plan can tell you what the hospital’s price will be for all your services as well as what your out-of-pocket, co-pay, and deductible will be.

Uninsured and self-pay patients can receive a Good Faith Estimate of Costs

Your patient rights by law as of January 1, 2022, seek to ensure that you have the right to a written estimate of your healthcare bill. It is called a “Good Faith Estimate”.

Our pain clinic patients have a right to this good faith estimate when:

  • You schedule your appointment 3 or more days in advance AND
  • You won’t be utilizing insurance to pay for the visit or if you do not have insurance coverage.

Avoid Confusion: Save a copy of your Good Faith Estimate

Your rights extend to providers not affiliated with The Minnesota Head & Neck Pain Clinic. A good faith estimate will include expected charges, including but not limited to lab charges, imaging, procedures, and supplies. It is always helpful if you save a copy of your bill and Good Faith Estimate in a safe and easy to locate place. If you receive a bill from us that is more than $400 above your estimate, you may dispute your bill within 120 days of receiving it. If you have questions regarding our internal billing processes you can contact our business office by calling (651) 332-7479 or by email: Always independently verify insurance coverage, provider participation, and coverage terms. This may not reflect all insurance accepted by the provider and is for informational purposes only. You will find tips for asking your questions for your insurance company on our patient’s page. Here is a list of Minnesota frequently used commercial insurance companies and their main customer service phone numbers:
Blue Cross and Blue Shield/Blue Plus of Minnesota 651-662-8000
HealthPartners 952-883-5000
Medica 952-945-8000
Metropolitan Health Plan 612-596-1036
PreferredOne 612-676-3200
Sanford Health Plan of Minnesota 605-328-6868
UCare 612-676-3200
NOTE: If you are insured, you should contact the phone number provided on your insurance card. The above is only a partial list of insurance companies. For example, there are national insurance companies. ADDITIONALLY, you should know that clinics are not permitted to assemble to set prices. That would be a violation of federal and state antitrust laws that protect you.

Additional information regarding your rights to a Good Faith Estimate is posted at:

  • National CMS: or call 800-985-3059.
  • Minnesota state law protections: how much patients covered by fully insured commercial plans will pay for certain unauthorized, non-emergency services and unauthorized emergency services. For more information about your rights under Minnesota state law, please contact the Minnesota Department of Commerce.

Our clinics conviently offers teleheath appointments. We are leaders in providing healthcare for chronic pain while avoiding risks of perscription adition.

Learn more about our clinic: you’re in good hands with our team of pain care specialists!


Our mission is to provide high-quality, effective patient care for head and neck disorders through a multispecialty, interdisciplinary approach designed to reduce pain and improve function for all our patients.

3475 Plymouth Blvd # 200, Minneapolis, MN 55447

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Fax: (651) 332-7475

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Fax: (952) 892-6477

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