Good Faith Estimate Notice
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the “No Surprise Act” law, health care providers give patients (who don’t have insurance or who are not using insurance) an estimate of the cost for medical services.
You have the right to receive a Good Faith Estimate for the total expected cost of any nonemergency services.
Your health care provider will give you a Good Faith Estimate at least one business day before initial services. You can also ask this health care provider (or any other provider) for a Good Faith Estimate before you schedule a service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Please save a copy of your Good Faith Estimate for your records.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.