Your Rights Against Surprise Medical Bills & Right to a Good Faith Estimate
Effective Date: June 21, 2026
Under federal and California state law, healthcare providers must give patients who do not have insurance, or who are not using insurance, an estimate of the total bill for medical items and services.
1. What is "Balance Billing" or "Surprise Billing"?
When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn't in your health plan’s network.
"Out-of-network" describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called balance billing.
Surprise billing is an unexpected balance bill. This commonly happens when you cannot control who is involved in your care—such as during an emergency or when you schedule a visit at an in-network facility but unexpectedly receive treatment from an out-of-network provider.
2. Our Practice Framework
At Donnielle James L.Ac, , we operate as an out-of-network provider. We believe in total financial transparency. We do not participate in hidden billing practices, and you will never receive an unexpected balance bill from our office. All fees for acupuncture, movement therapy, and clinical assessments are clearly stated upfront before care is delivered.
3. Your Right to a "Good Faith Estimate"
You have the right to receive a written Good Faith Estimate (GFE) explaining how much your medical care will cost before you receive services.
Upfront Pricing: You have the right to receive a Good Faith Estimate for the total expected cost of your care, including initial consultations, standard acupuncture treatments, or clinical movement sessions.
Timing: We will provide your written Good Faith Estimate at least one (1) business day before your scheduled medical service or treatment. You can also request a Good Faith Estimate before you schedule an appointment.
Right to Dispute: If you receive a bill from our office that is at least $400 more than your written Good Faith Estimate, federal law permits you to dispute the bill through a consumer protection process.
Record Keeping: Ensure you save a digital copy or take a picture of your written Good Faith Estimate for your records.
Questions or More Information
For questions or more information about your right to a Good Faith Estimate or protections against surprise billing under federal or California law, you can visit www.cms.gov/nosurprises or call the federal helpdesk at 1-800-985-3059.
You can also contact the California Department of Managed Health Care (DMHC) or the California Department of Insurance for state-specific protections.