Patient information
Know your costs before care.
You have the right to receive a Good Faith Estimate explaining the expected cost of your health care if you are uninsured or are not using insurance to pay for the care.
What the estimate covers
The estimate lists expected charges for non-emergency items and services, including related costs reasonably expected as part of your care. Ask each provider involved in your treatment for an estimate.
When you will receive it
- If you schedule care 3–9 business days ahead, the estimate is due within 1 business day after scheduling.
- If you schedule care at least 10 business days ahead, the estimate is due within 3 business days after scheduling.
- You can request an estimate before scheduling; it is due within 3 business days of your request.
- Keep a copy or photo of your written estimate.
If your bill is higher
If a provider or facility bills you at least $400 more than its Good Faith Estimate, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process. Generally, you must start that process within 120 calendar days of the initial bill.
Questions or an estimate request?
Call Royalty Dental at (818) 705-6565.
Federal information and help: CMS.gov/NoSurprises · 1-800-985-3059 (No Surprises Help Desk).