YOUR RIGHT TO A GOOD FAITH ESTIMATEEffective January 1, 2022, under the federal No Surprises Act (45 CFR §149.610), all patients who are uninsured or who choose not to use their insurance have the right to receive a written Good Faith Estimate (GFE) of expected charges before receiving care.YOUR RIGHTS• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services before your appointment.• Your estimate must be provided in writing at least 1 business day before your scheduled service, or within 3 business days of your request.• You can also ask for a Good Faith Estimate before you schedule any service.• If your actual bill is $400 or more above your Good Faith Estimate, you have the right to dispute the charge through the federal Patient-Provider Dispute Resolution process. Save a copy of your estimate.• For more information, visit cms.gov/nosurprises
HOW TO REQUEST YOUR ESTIMATE
Contact us before your appointment:
Phone: (425) 576-5433 Email: office@kirklandlife.com
Please let us know which service(s) you are booking and whether you are paying out of pocket or using insurance. We will provide your written estimate promptly.
ABOUT OUR PROVIDERS & BILLING :Dr. Jeremy Heisler, D.C. (owner) provides chiropractic services through Kirkland Life Chiropractic. Insurance may apply for covered chiropractic care depending on your plan.
All other practitioners at this location — including massage therapy (Julene Page, LMP), stretching & body tempering (Jason Balajadia), craniosacral therapy (Brigitta Bolanos, LMP), and energy, sound & light healing (Katy Tenhulzen, Reiki Master) — are independent licensed contractors. Their services are provided on a self-pay basis unless otherwise noted.Exception: Julene Page, LMP accepts personal injury (PIP/auto accident) and Washington State L&I (workers' compensation) billing for qualifying massage therapy patients. Please contact us before booking if you have an open auto or L&I claim.
SUPERBILLSFor self-pay wellness services, a superbill may be provided upon request after your appointment. A superbill is a detailed receipt containing the individual provider's license number, NPI if applicable, CPT codes if applicable, and date of service that you may submit to your insurer for potential out-of-network reimbursement. Reimbursement is not guaranteed and depends on your plan's out-of-network benefits.Kirkland Life Chiropractic | 13116 NE 70th Pl, Kirkland, WA 98033(425) 576-5433 | office@kirklandlife.com
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The information on this site is provided for your assistance only; this site does not provide chiropractic advice. You should never diagnose or treat yourself for a chiropractic condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for chiropractic care provided by a licensed chiropractic professional. The information provided herein is not chiropractic, medical or professional advice. This site does not create a doctor-patient relationship.
The Doctors and Kirkland Life Chiropractic, P.S. expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. The Doctors and Kirkland Life Chiropractic, P.S. further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will the Doctors and Kirkland Life Chiropractic, P.S. be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
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