New Patient Form (pdf)
DownloadYou have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.
Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided. To read the full statement, please visit this link.
If you are unsure of your insurance in-network providers, please contact Member Services on the back of your insurance card to ensure our Practice is a participant of your plan.
For questions or more information about your right to a Good Faith Estimate, please call 925.478.4535 Monday through Thursday between 7:30 AM and 4:00 PM or Friday 8:00 AM to 1:00 PM to speak with our office Admin Team.
Are you planning to receive treatment at CHI Dermatology? We want to ensure cost transparency for uninsured and self-pay patients. The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
For questions or more information about your right to a Good Faith Estimate, please call 925.478.4535 Monday through Thursday between 7:30 AM and 4:00 PM or Friday 8:00 AM to 1:00 PM to speak with our office Admin Team or visit our website at https://chidermatology.com .
CHI Dermatology
120 La Casa Via, Suite 107, Walnut Creek, CA 94598
phone: 925-478-4535 / fax: 925-430-5340
Copyright © 2023 CHI Dermatology - All Rights Reserved.
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