Good Faith Estimate Notice

Effective date: October 25, 2026

Know the expected cost when not using insurance

If you are uninsured or choose not to use your health insurance for nonemergency care, federal law may entitle you to a written Good Faith Estimate of expected charges. This applies to qualifying MyTeleHealthPoint self-pay services even though we do not submit consultation claims to insurers.

When an estimate is provided

• On request: Generally within three business days after you request a Good Faith Estimate.
• Scheduled three to nine business days ahead: Generally within one business day after scheduling.
• Scheduled ten or more business days ahead: Generally within three business days after scheduling.
• Same-day or next-two-business-day care: Federal advance-scheduling rules generally do not require an automatic estimate, but you may still ask for one. The applicable request timeframe continues to apply.

An estimate is not a bill or guarantee of treatment. It should itemize the expected charges we are required to estimate. Laboratory, pharmacy, and other outside providers may give separate estimates for services they independently provide and bill. We will disclose known additional charges before you agree whenever feasible.

If a bill is higher than the estimate

If a qualifying bill from a provider is at least $400 more than that provider's Good Faith Estimate, you may be eligible for the federal patient-provider dispute resolution process, generally within 120 calendar days of the initial bill. See https://www.cms.gov/medical-bill-rights or call the No Surprises Help Desk at 1-800-985-3059. You may also contact us directly about billing discrepancies.

To request an estimate, use our website Contact page and select Billing / Good Faith Estimate, or request assistance through secure Spruce: https://spruce.care/mytelehealthpoint. Telephone alternative: (216) 438-0004. We will not retaliate against you for asserting billing rights.

OWNER-APPROVED: Olumide B. Ogunwumi, PA-C | October 25, 2026 · Version October 25, 2026