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Forms & Links

New paient papwerwork
NEW PATIENT PAPERWORK (Fill out if directed to by staff)
GOOD FAITH ESTIMATE/NO SURPRISES ACT

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 1 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 or call 800-985-3059.

Contact

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Arbor Psychiatric & Wellness Center

1120 6th Corso

Nebraska City, NE 68410

Phone: 402.713.0110

Fax: 402.713.0285

E-mail: info@arborpwc.com

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Patient Portal Link

Hours:

Monday           9:00AM to 5:00PM

Tuesday           9:00AM to 5:00PM

Wednesday     9:00AM to 5:00PM

Thursday         9:00AM to 5:00PM

Friday              No Providers in Office

*After hours appointments may be accommodated

on an individual need basis

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