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Policies & Notices

Good Faith Estimate

Your rights to a Good Faith Estimate for telehealth services with Awaken Women’s Health and what to do if a bill differs.

Effective: January 1, 2024Last reviewed: January 1, 2024

Your protections

  • You are protected from surprise billing for emergency services and certain out-of-network care at in-network facilities under the No Surprises Act.
  • For uninsured or self-pay patients, you can request a Good Faith Estimate (GFE) of expected charges before you schedule or at any time.
  • If you receive a bill that is at least $400 more than your GFE, you can start a payment dispute process within 120 days of the bill date.

Telehealth-only services

Awaken Women’s Health is currently telehealth-only in Washington and Utah. We will describe the technology used, privacy safeguards, and how to report telehealth complaints in each state. For emergencies, call 911 or go to the nearest emergency room.

How to request a GFE

  • Contact us before scheduling to request a GFE for uninsured or self-pay services.
  • We will provide the estimate within the timelines required by federal rules.
  • Keep a copy of your estimate; it is used for any dispute process.

If you think you were billed incorrectly

  • Start a payment dispute if your bill is $400+ above the GFE.
  • You can also contact us to review the bill and estimate together.
  • You may contact state regulators (WA Department of Health; Utah Division of Occupational and Professional Licensing) if you have questions or complaints about telehealth billing—final contact details will be added here.

Contacts

  • Billing / disputes contact: (253) 234-7412, info@awakenwomenshealth.com
  • State contacts: WA and UT complaint contacts for telehealth/billing will be listed once confirmed.
  • PDF version: A printable PDF of this notice will be posted when available.