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No Surprises Act GFE Notice

Your Right to a Good Faith Estimate

California Imaging and Diagnostics Medical Group, LLC

What Is a Good Faith Estimate?

You have the right to receive a Good Faith Estimate explaining how much your medical care will cost before you receive services.

Under the law, healthcare providers are required to give patients who don’t have insurance — or who are not using their insurance — a written estimate of the expected charges for medical services, including all items and services reasonably expected to be provided in connection with your visit.

Your Rights Under the No Surprises Act

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including all diagnostic imaging, X-rays, CT scans, MRIs, ultrasounds, mammography, nuclear medicine studies, bone density scans, biopsies, and all other diagnostic and therapeutic procedures offered by California Imaging and Diagnostics.

Specifically, you have the right to:

  • Receive a written Good Faith Estimate at least 1 business day before your scheduled service
  • Ask for a Good Faith Estimate at any time before you schedule a service — you do not need to wait until a service is scheduled
  • Dispute a bill if the final charges are at least $400 more than the amount shown on your Good Faith Estimate

Important Things to Know

  • Your Good Faith Estimate is not a contract and does not require you to obtain the listed services
  • Actual costs may be higher or lower than the estimate depending on what occurs during your appointment
  • The estimate covers charges from California Imaging and Diagnostics only — it does not include charges from your referring physician, specialist, or other separate providers
  • If you have questions about your estimate, contact us before your appointment using the information below

How to Request a Good Faith Estimate

To request a Good Faith Estimate before scheduling a service, or if you have questions about your estimated costs, contact us at:

California Imaging and Diagnostics — Hemet 

850 E. Latham Ave., Suite 101, Hemet, CA 92543

Phone: (866) 419-3372 | Fax: 951-677-7839

California Imaging and Diagnostics — Murrieta 

25470 Medical Center Dr., Suite 101, Murrieta, CA 92562

Phone: (866) 419-3372 | Fax: 951-677-7839

Email: info@cidrad.com

Hours: Monday–Friday, 8:00 AM – 5:00 PM PST

How to Dispute a Bill

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Save a copy or take a picture of your Good Faith Estimate when you receive it so you can refer to it later.

For information on the dispute resolution process, visit www.cms.gov/nosurprises or call 1-800-985-3059.

More Information

For questions or more information about your right to a Good Faith Estimate:

www.cms.gov/nosurprises | Phone: 1-800-985-3059

This notice is provided in compliance with the No Surprises Act (Pub. L. 116-260), effective January 1, 2022, and implementing regulations at 45 C.F.R. § 149.610.