Good Faith Estimate Rights

Highland Dental, PLLC
Effective date: November 1, 2026

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost

Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

• You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling those items or services. This includes related costs such as medical tests, prescription drugs, equipment, and hospital fees.
• If you schedule a health care item or service 3–9 business days in advance, your health care provider or facility must give you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule at least 10 business days in advance, your provider or facility must give you a Good Faith Estimate in writing within 3 business days after scheduling.
• You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, your provider or facility must give you a Good Faith Estimate in writing within 3 business days after you ask.
• If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
• Keep a copy or picture of your Good Faith Estimate.

To request an estimate from Highland Dental

Call (615) 754-6677(615) 754-6677. Highland Dental, PLLC is located at 631 South Mt. Juliet Road, Mt. Juliet, TN 37122.

Questions about your rights?

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.