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Galactic Sedation Solutions

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:
00170 - Anesthesia for procedures on salivary glands, including biopsy
42820 - Biopsy of salivary gland


Do anesthesiology practices need to provide good faith estimates?

Anesthesiology practices must provide good faith estimates to patients who require it.

Are anesthesiologists subject to GFE regulations?

All anesthesia providers, including anesthesiologists and nurse anesthetists, must comply with good faith estimate regulations.

What type of patients do anesthesiology practices need to provide with accurate and reliable cost estimates?

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

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 while reducing staffing expenses and eliminating stress for anesthesiology practices

Comply with the No Surprises Act's legal requirements on Good Faith Estimates for anesthesiology practices and eliminate the burden of hiring dedicated staff for a repetitive task. Our automated email/text estimates satisfy HIPAA-compliant encryption standards with two-factor authentication, while paper estimates are also available for patient preferences.

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Streamline your anesthesiology practice's finances by automating benefits verification to minimize debt and administrative expenses

Automated eligibility verification enables your anesthesiology practice to efficiently process patients, decreasing administrative costs as your patient volume increases. This ensures accurate billing, prior-authorization awareness and minimizes back-end denials that result in bad debt.

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Enhance anesthesia revenue while accelerating payment processing and elevating patient satisfaction

Increase patient trust and encourage upfront deposits beyond co-pays by providing transparent out-of-pocket projections in advance of treatment. Allow patients to conveniently make deposits through our online estimates to eliminate the burden of front-desk collections during service.


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

Get paid in full by bringing clarity to your revenue cycle