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Jedi Allergy Clinic

Good Faith Estimate for Health Care Items and Services

Patient Identification Number: 156749125
Evergreen Ave
Mountain City, CO 34510
The following is a detailed list of expected chargers for the appointment scheduled for 11/2/2023. The estimated costs are valid for 12 months from the date of the Good Faith Estimate.
Details for Services and Items for appointment located at Mountain City:
95004 - Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report.
95115 - Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection.


Do allergy practices need to provide good faith estimates for their services?

Allergy practices are required to provide good faith estimates to patients who need them.

Are allergy practices subject to GFE regulations?

Allergy practices, including allergists and immunologists, must comply with good faith estimate regulations, just like all healthcare providers.

What type of allergy patients are required to receive good faith estimates?

Allergy practices must comply with the No Surprises Act, which requires them to provide good faith estimates to uninsured and self-paying patients.

Achieve compliance and boost collections at the same time

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Automatically send Good Faith Estimates via email, text, or letters

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Project out-of-pocket costs

Generate accurate estimates for patients that include deductibles, copays, and coinsurance.

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Unlock upfront payments

Enable patients to make upfront deposits and payment plan elections online, directly from their estimates.

3 wins for your 



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Ensure No Surprises Act compliance for allergy practices without incurring additional staffing expenses or operational challenges

We understand that complying with the legal requirements of the No Surprises Act's Good Faith Estimates can be a burden on allergy practices. That's why we offer an automated email/text estimate system that's HIPAA-compliant and encrypted with two-factor authentication. This saves you from having to hire and train full-time staff for this endlessly repetitive task. And for patients who prefer a paper estimate, we've got that covered too.

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Efficiently manage your allergy practice's administrative costs and minimize bad debt through automating benefits checks

Automated eligibility verification is a smart solution for allergy practices looking to increase efficiency and reduce admin costs while keeping up with patient volume. With this tool, you can easily bill the correct payer, stay on top of prior-authorization requirements, and prevent costly denials that could impact your bottom line.

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Boost allergy patient collections and receive payments more rapidly, all while enhancing patient experience

Offer your allergy patients peace of mind by providing transparent out-of-pocket projections before their appointment. Encourage them to make upfront deposits online for co-pays and beyond, eliminating the need for your front-desk staff to handle this task during their visit.


MD Clarity works with the tools you use to run your practice.

Get paid in full by bringing clarity to your revenue cycle