A healthcare professional in scrubs hands a clipboard with a form to a woman wearing a hijab during a consultation in a bright, modern office.

Patient Resources

Quickly access the information you need to prepare for care, understand your options, and move forward with confidence.

Helpful Information. Easier Access to Care.

Find important forms, notices, and financial assistance information to help you access care at MHEDS.
Use the resources below to review your privacy rights, learn about our Sliding Fee Discount Program, and understand your right to a Good Faith Estimate.

Documents

Review our document directory to assist you in getting the services that you require while maintaining your privacy.

HIPAA/Notice of Privacy Practices

MHEDS HIPPA Patient Privacy Complaint Form

MHEDS Notice of Privacy Practices

Sliding Fee Scale Application

MHEDS Sliding Fee Scale

MHEDS Sliding Fee Discount Application

2026 FPL Guidelines

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 are required to give an estimate of the cost for medical services and items to patients who are not insured or who are not using an insurance estimate of the bill for medical services and items.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes medical tests, prescription drugs, equipment, and hospital fees.

If you want a Good Faith Estimate, make sure your health care provider gives it to you in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, 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 www.cms.gov/nosurprises or call 215-861-4633.