Patient Provider Dispute Resolution (PPDR)
Information on Internal and External dispute process
If your invoice amount is $400 or more above the estimated cost from your GFE, you can call (630) 682-7400 and you will be directed to staff that will assist with your billing concern. Staff will review your client statement with the clinical service record to identify if any errors were made in the determination of your fees.
After speaking with our staff, if it was determined that the charges were $400 over the GFE you may be eligible to dispute your bill.
Eligibility Requirements
- Individuals who are uninsured, self-pay, or who are insured but declined to use their insurance at the time of service.
- An individual who scheduled or received the medical items or services on or after January 1, 2022.
- An individual who has received a GFE from their provider.
- An individual with a bill dated within the last 120 calendar days (about 4 months).
- The difference between the GFE and the bill from any single provider or facility is at least $400.
There is a $25 non-refundable fee to initiate this process.
Please view this link to start a dispute.
Disclaimer: You are eligible for the Patient Provider Dispute Resolution process only if your bill from an individual provider or a facility is at least $400 or more than the total expected cost on the Good Faith Estimate from that provider or facility.
Note: clients are responsible for any and all self-pay balances.
Last Updated: 4/24/2023