Good Faith Estimate

Beginning January 1, 2022, Community Health Centers, such as Shenandoah Community Health (SCH), are required to provide uninsured or self-pay patients with a Good Faith Estimate (GFE) of their expected out-of-pocket costs for services before care is received, as long as the appointment is scheduled at least three days in advance, or otherwise requests a GFE. This requirement is based on U.S. Department of Health & Human Services “No Surprises Act” passed in December 2020.

The GFE will include charge information for:

• the primary service SCH expects to provide to the patient during the “period of care.”
• the items and/or services that are “reasonably expected” to be provided “in conjunction with the primary service” for which SCH, or an outside provider, has a separate charge.

For more information, or to request a GFE, call:
SCH Behavioral Health | Martinsburg, 304-263-7023
SCH Behavioral Health | Charles Town, 304-728-3716
Healthy Smiles, 304-267-0250
SCH Primary Care | Martinsburg, 304-263-4999
SCH Women’s Health | Martinsburg, 304-263-4999
SCH Winchester, 540-722-2369

This Good Faith Estimate is based on our understanding of your needs as of today. While caring for you, our providers may recommend additional services that are not listed on the GFE. Your actual charges may vary from this estimate. This estimate is not a contract and does not require you to get services from SCH. If your actual charges are more than $400 above this estimate, you can initiate a provider-patient dispute resolution process by calling 304-263-4999 ext. 1075. Starting a dispute resolution process will not reduce the quality of health services you receive at SCH.

For additional dispute information click here.