Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your health care will cost if: 

                               o You do not have insurance

                               o You are not using insurance

                               o Your insurance is out-of-network

Under the law, health care providers need to give such patients an estimate of the bill for health care services. This is called a Good Faith Estimate. 

You have the right to receive a Good Faith Estimate for total expected cost of any health care items of service. The good Faith Estimate shows the total expected cost of any non-emergency items or services.

You may request a Good Faith Estimate in advance of an already scheduled healthcare service or item or before scheduling 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 or the dispute process please visit:   

                                                    - www.cms.gov/nosurprises 

                                                    - or call 1-800-985-3059