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Galactic Urgent Care Center (GUCC)

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:
99213 - Office or other outpatient visit
81002 - Urinalysis, non-automated, without microscopy


Do urgent care practices need to provide good faith estimates to their patients?

Urgent care practices are required to provide good faith estimates to patients who need them in certain situations.

Are urgent care practices required to comply with GFE regulations for all their doctors?

Urgent care practices are required to follow good faith estimate regulations, regardless of the type of provider.

What patients at urgent care practices are required to receive good faith estimates?

If an urgent care center arranges a follow-up appointment for a self-pay or uninsured patient more than three business days in advance, a Good Faith Estimate (GFE) would be necessary.

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 

Urgent Care


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Ensure No Surprises Act compliance for your urgent care practice without the added expense or stress of extra staffing requirements.

Get your urgent care practice compliant with the legal requirements of the No Surprises Act with our help. We can save you from the expense of hiring full-time staff dedicated to Good Faith Estimates. Our automated email/text estimates are fully encrypted and HIPAA-compliant, and come with two-factor authentication. We also provide paper estimates for patients who prefer them.

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Maximize your urgent care practice's financial health by automating benefits checks and reducing administrative costs.

Increase your urgent care practice's efficiency with automated eligibility verification. Save on admin costs while handling a growing patient volume and ensuring accurate billing to the correct payer. Avoid back-end denials and bad debt by easily identifying when prior-authorization is needed.

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Boost revenue from patient collections and expedite payments, specifically enhancing the urgent care patient experience.

Empower your urgent care patients to confidently receive care by providing them with clear out-of-pocket projections prior to service, encouraging upfront deposits that exceed their co-pays. Save your front-desk staff from inefficient and awkward exchanges by allowing patients to make deposits directly from our online estimates.


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

Improve your financial performance while providing a more transparent patient experience