Information on Charges and Good Faith Estimates

This notice provides information on Patient First’s Self-Pay Program and your right to request a Good Faith Estimate of reasonably expected charges during your visit.

If you are experiencing a medical emergency, please call 911 or proceed immediately to the nearest emergency room.

Self-Pay ProgramPatient First offers uninsured patients simplified pricing with discounted rates. The program caps the cost of most services provided at Patient First at $314, with exceptions for some services like outside lab testing, prescription drugs, and vaccines. The Self-Pay Program is not available to patients who have insurance.

Benefits of the Self-Pay Program include the ability to receive services today, without waiting for an estimate of charges. Please visit us at for more information.

Good Faith EstimatesIf you are uninsured or have commercial insurance that you do not wish to use, you have the right to request a Good Faith Estimate (“GFE”) explaining how much your services at Patient First (and any related services that we can reasonably predict based on your complaint) will cost. Patients with government health insurance (Medicare, Medicare Advantage, Medicaid, and Tricare) are not eligible for a GFE.

  • You must request a GFE before receiving services; you may not receive services today and request a GFE for those services after receiving them.
  • Request a Good Faith Estimate by writing to or to Patient First, 5000 Cox Road, Glen Allen, VA 23060, Attention: General Counsel.
  • Include your name, date of birth, address, insurance status and name of insurer (if any), and a description of the reason for your upcoming visit. Incomplete requests will not be processed. Please also tell us if you would like us to reply via encrypted email or U.S. mail.
  • We will send you a response by encrypted email or U.S. mail within three (3) business days of our receipt of your request. If you do not tell us how you want us to reply, we will reply by encrypted email.
  • Your GFE will include the estimated cost of laboratory tests, prescription drugs, imaging services, and other items and services, to the extent we can reasonably anticipate that they will be required based on the reason for your visit.
  • Based on your providers’ evaluation, you may require tests or services that are not described in your GFE. If the actual charges for services provided by any health care provider exceed the GFE by $400 or more, you may dispute the bill. Your GFE will include information about the dispute process.
  • If you would like to receive an estimate regarding the cost of services that may be provided to you sooner than 3 business days, please review Patient First’s Self-Pay Program (described above).
  • Please remember that patients with commercial insurance may request a GFE but are not eligible for the Patient First Self-Pay Program.