Last updated: August 2026

Under the federal No Surprises Act, you have the right to receive a Good Faith Estimate of what your care will cost. This notice explains that right and how to use it at Pineapple Chiropractic and Podiatry.

Who this is for

You have the right to a Good Faith Estimate for the total expected cost of your care if you are uninsured, or if you are insured but choose not to use your insurance and pay on your own (self-pay). The estimate covers the services you are expected to receive, such as examinations, chiropractic adjustments, podiatric care, and any related items or services.

How to request one

You can ask any member of our office for a Good Faith Estimate before you schedule care, and we will provide one. If you schedule a service at least a few business days in advance, you will also receive an estimate automatically. You can request an estimate at any time, in person, by phone, or by email, and we are happy to walk you through it.

If your bill is higher than your estimate

If you receive a bill that is at least $400 more than your Good Faith Estimate for any provider or facility listed on that estimate, you have the right to dispute the bill through the federal patient-provider dispute resolution process. The bill and the estimate must be for the same items and services.

Keep a copy

Make sure to save a copy or picture of your Good Faith Estimate in case you need it later. You may want it if a bill comes in higher than expected.

This is a notice of your rights

A Good Faith Estimate shows the costs of items and services that are reasonably expected. The actual items, services, or charges may differ from the estimate. This document is a notice of your rights and is not a contract or an offer to enter into one. It does not require you to receive any of the services listed.

Learn more

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call our office. To request an estimate or ask a question, contact:

Pineapple Chiropractic and Podiatry, Dr. Hyunjae Lee, DC, DPM
842 Clifton Ave, Ste 6, Clifton, NJ 07013
Phone: (212) 884-4229
Email: Dr.lee.dc.dpm@gmail.com