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Patient Estimates

Disclaimer

I acknowledge and understand that this is just an estimate based on the information that I (the patient) have entered into the system. I understand that additional or different services may be ordered by the provider that may not be included in this estimate and the price I pay may be higher or lower than this estimate states. I also understand that Altru Health System and its Affiliates cannot guarantee coverage or payment by my insurance provider and that this estimate does not include any changes to my insurance coverage or benefits (such as deductibles, co-insurances, etc.). I understand that I can contact my insurance company directly to determine if the services are a covered benefit and that I am aware of my financial responsibility as it relates to my insurance coverage.

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