Eras Women's Health, LLC

Notice of Good Faith Estimate

You have the right to receive a Good Faith Estimate of what your care is expected to cost before you receive services.

Under the No Surprises Act (effective January 1, 2022), health care providers are required to give patients who are uninsured or self-pay a written estimate of expected charges before services are provided.

This notice applies to you if you are uninsured, or if you have insurance but choose to pay out of pocket without submitting a claim to your insurer. It does not apply to services billed to Medicare, Medicaid, TRICARE, or other federal health programs.

What to Expect

When you schedule an appointment at least 3 business days in advance, we will automatically provide you a written Good Faith Estimate. You may also request one at any time — simply ask when you call or message us.

Your estimate will include an itemized list of services expected to be provided, the expected charge for each, applicable diagnosis and service codes, and the name and NPI of Eras Women's Health, LLC. Charges for outside services such as labs, imaging, or DEXA scans performed by third parties will be noted separately to the extent known.

Delivery timelines:

Important Disclosures

A Good Faith Estimate is an estimate, not a final bill and not a contract. It does not require you to receive services from Eras Women's Health. Actual charges may differ if the care you receive changes. For Metabolic Reset Program members, GLP/GIP medication costs are billed separately at cost and will be itemized in your estimate.

If Your Bill Is Higher Than Your Estimate

If you receive a bill that is $400 or more higher than your Good Faith Estimate from any single provider, you have the right to dispute the bill through the federal Patient-Provider Dispute Resolution (PPDR) process. You must initiate the dispute within 120 days of receiving your bill. While a dispute is open, we will not send your account to collections or charge late fees. Disputing a bill will not affect the quality of care you receive.

To learn more or file a dispute: cms.gov/nosurprises/consumers or call 1-800-985-3059.

Request an Estimate or Ask a Question

Contact us any time — before or after scheduling:

Phone

[Clinic Phone Number]

Secure Message

Passport Patient Portal

Email

[Billing Email]

Questions / Complaints

Arkansas Insurance Dept.
insurance.arkansas.gov · 800-852-5494

This notice is provided in compliance with Section 2799B-6 of the Public Health Service Act and 45 C.F.R. § 149.610. It is available in accessible formats and upon request in languages other than English. Last reviewed: March 2026.
Good Faith Estimate | Eras Women's Health

Eras Women's Health, LLC

Notice of Good Faith Estimate

You have the right to receive a Good Faith Estimate of what your care is expected to cost before you receive services.

Under the No Surprises Act (effective January 1, 2022), health care providers are required to give patients who are uninsured or self-pay a written estimate of expected charges before services are provided.

This notice applies to you if you are uninsured, or if you have insurance but choose to pay out of pocket without submitting a claim to your insurer. It does not apply to services billed to Medicare, Medicaid, TRICARE, or other federal health programs.

What to Expect

When you schedule an appointment at least 3 business days in advance, we will automatically provide you a written Good Faith Estimate. You may also request one at any time — simply ask when you call or message us.

Your estimate will include an itemized list of services expected to be provided, the expected charge for each, applicable diagnosis and service codes, and the name and NPI of Eras Women's Health, LLC. Charges for outside services such as labs, imaging, or DEXA scans performed by third parties will be noted separately to the extent known.

Delivery timelines:

Important Disclosures

A Good Faith Estimate is an estimate, not a final bill and not a contract. It does not require you to receive services from Eras Women's Health. Actual charges may differ if the care you receive changes. For Metabolic Reset Program members, GLP/GIP medication costs are billed separately at cost and will be itemized in your estimate.

If Your Bill Is Higher Than Your Estimate

If you receive a bill that is $400 or more higher than your Good Faith Estimate from any single provider, you have the right to dispute the bill through the federal Patient-Provider Dispute Resolution (PPDR) process. You must initiate the dispute within 120 days of receiving your bill. While a dispute is open, we will not send your account to collections or charge late fees. Disputing a bill will not affect the quality of care you receive.

To learn more or file a dispute: cms.gov/nosurprises/consumers or call 1-800-985-3059.

Request an Estimate or Ask a Question

Contact us any time — before or after scheduling:

Phone

[Clinic Phone Number]

Secure Message

Passport Patient Portal

Email

[Billing Email]

Questions / Complaints

Arkansas Insurance Dept.
insurance.arkansas.gov · 800-852-5494

This notice is provided in compliance with Section 2799B-6 of the Public Health Service Act and 45 C.F.R. § 149.610. It is available in accessible formats and upon request in languages other than English. Last reviewed: March 2026.