Notices
Good Faith Estimate
If you don’t have insurance, or do have insurance and are choosing not to use it to pay for your care at HealthWorks, please let us know in advance so we can provide a good faith estimate of your expected charges. You may choose not to use insurance if the service you need isn’t covered, or it’s less expensive if you pay out of pocket.
In most cases, we can give you an estimate when you schedule care at least 3 business days in advance, or if you ask for one.
If your bill is at least $400 more than the good faith estimate we provided, you can dispute your bill.
To learn more about good faith estimates, visit CMS.gov.
Deeming Notice / Federal Tort Claims Act
Cheyenne Health and Wellness Center (dba HealthWorks) is a federally qualified health center that, along with its employees, directors, and certain contractors, is deemed by the Bureau of Primary Health Care of the U.S. Department of Health and Human Services to be a federal employee for purposes of medical malpractice claims. The only remedy for an individual who has a medical malpractice claim against the health center and/or its employees, directors, and contractors is to file an administrative claim under the Federal Tort Claims Act with the U.S. Dept. of Health and Human Services at the following address:
Office of the General Counsel
General Law Division
Claims and Employment Law Branch
330 Independence Avenue, SW, Suite 2600
Washington, D.C., 20201
Attention: CLAIMS
Phone: (202) 233-0233
Fax: (202) 691.2035
Email: gcgl@hhs.gov
This health center is a Health Center Program grantee under 42 U.S.C.254b, and a deemed Public Health Service employee under 42 U.S.C. 233(g)-(n).
HRSA Notice
This Health Center is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number H80CS04196, Health Center Program for $1,732,324.00. Sixty-Three percent (63%) of the health center’s budget is financed with nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
Notice of Nondiscrimination
HealthWorks complies with applicable Federal civil rights laws and does not discriminate based on race, color, national origin, age, disability, or sex, sexual orientation, or gender identity. HealthWorks does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, sexual orientation, or gender identity.
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Click here to review the document (.PDF) in English, or click here to review the document in Spanish.