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Under Federal Law, healthcare providers are required to provide you with a Good Faith Estimate that summarizes the full anticipated cost of your medical care if you do not have medical insurance or choose not to utilize it for any reason.

  • You have the right to receive a Good Faith Estimate of the amount you will be billed for scheduled or non-emergency items or services. This includes the costs of items and services anticipated to be provided during the visit, such as medical tests, hospital fees, or prescription drugs.
  • You are entitled to receive your Good Faith Estimate in writing at least 1 business day before your medical care. In the event that the service is emergent or additional testing is performed during your visit, you will receive a Good Faith Estimate at the time of care.
  • You can also request a Good Faith Estimate from your healthcare provider before you schedule a service. This estimate will be based on the information available at the time of scheduling. Please be advised that the exact cost of care cannot be determined until the evaluation takes place as the physician may recommend or require additional services. 
  • Whether or not you have insurance, if you receive a bill that is at least $400 more than the Good Faith Estimate provided for your treatment, you are able to dispute the bill under the new patient-provider dispute resolution.
  • Please save a copy or picture of your Good Faith Estimate. 


For additional questions or concerns regarding your rights under the No Surprises Act, please visit  

About Our Practice

Maida Custom Vision Doctors and Staff

Dr. Jerry Maida and his staff want to give you the ability to see every detail.

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Our Location

Our Location (click to view contact page)

Maida Custom Vision - Mandarin Office
11945 San Jose Blvd Ste 102
Jacksonville, Florida 32223

Phone: (904) 268-3937

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