GOOD FAITH ESTIMATE

Good Faith Estimate:  No Surprises Act – Effective January 1, 2022

Under the law, all health care providers are required to give those who do not have insurance or who are not using insurance, an estimate of the amount they will be billed for scheduled items or services or upon request.  You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. Make sure that you receive the estimate in writing at least 1 business day before your scheduled 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 from that provider, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit
www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.