Policies
Your right to receive a Good Faith Estimate
Under the federal No Surprises Act, if you pay without using insurance you have the right to a good faith estimate: a written estimate of what your care will cost. With us it is simple: there are three visit types, each the same price for all ages: a doctor visit, US$79; a follow-up visit, US$49; and school and work forms, US$35. We charge nothing more without your consent.
Notice: your right to a Good Faith Estimate
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost. Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises (opens in a new tab) or call 1-800-985-3059.
Our good faith estimate: three visit types
Every visit is a real-time video visit with Dr. Diana Nieves Castro, MD, for adults and children of all ages. The total expected cost from us is the price of the visit type you choose:
- Doctor visit: US$79. A new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, visitors and chronic care.
- Follow-up visit: US$49. A refill of a medicine you already take (non-controlled), which anyone can book, or a review of lab results, for existing patients only.
- School and work forms: US$35. School, university or job forms, and the lab order for the certificado de salud. Does not include forms that need a vision exam.
- A doctor's note after your visit is included at no extra charge. Other charges from us: none.
If you move to a full doctor visit
If, in a follow-up or forms visit, the doctor finds you need a full doctor visit, she explains why and, only with your consent, you pay the difference. In that case the total cost from us is US$79, and we give you an updated written Good Faith Estimate. See the terms of service.
What's not included
The estimate covers only what we charge. It does not include what other providers charge if the doctor refers you: lab tests (billed by the lab), medications (billed by the pharmacy) or an in-person visit (billed by whoever sees you). Ask them for their own estimate.
When you get it
Because we charge the price of your visit when you request it, you know it from the start. We also give you the Good Faith Estimate in writing: if your visit is scheduled at least 3 business days ahead, no later than 1 business day after scheduling; and if you ask for it, no later than 3 business days after your request. It becomes part of your record.
How to request one
Email [email protected] and tell us whether you prefer it on paper or by email. You can ask before you request a visit. Prices are also on the pricing page.
If your bill is US$400 or more over the estimate
If you get a bill that is at least US$400 more than the total of your Good Faith Estimate, you can start the federal patient-provider dispute resolution process. You must start it within 120 calendar days of receiving the bill. Because our prices are fixed, we do not expect this to happen; if you think we overcharged you, email us first. See also the cancellation and refund policy.
Sources (3)
- 45 CFR 149.610: Good Faith Estimates for uninsured or self-pay individuals (opens in a new tab) (accessed 2026-09-30)
- 45 CFR 149.620: patient-provider dispute resolution (opens in a new tab) (accessed 2026-09-30)
- Understanding costs in advance (CMS, No Surprises) (opens in a new tab) (accessed 2026-09-30)
