If you don’t have insurance (Self Pay) or are not using your insurance. (Right to Restrict form completed)

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

When can I get a Good Faith Estimate?

  • At least 1 business day before your medical service or item.
  • You can also ask your health care providers for a Good Faith Estimate before you schedule an item or service.

What if my final total is higher than the Good Faith Estimate?

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

To request a Good Faith Estimate

Call Lancaster Radiology Associates Billing office (RDI) at 717-394-6028/

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

Visit cms.gov/NoSurprises or call 1-800-985-3059 for more information about your rights under federal law.