You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
In accordance to the Good Faith Estimate provision under the No Surprises Act, health care providers must give patients who don’t have insurance or who are choosing not to use insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare 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 you save a copy or picture of the Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
Disputing a Good Faith Estimate
You have the right to initiate the patient-provider dispute resolution process if the actual billed charges are $400 more than the expected charges included in the good faith estimate.
- To start the process, you may contact us at the phone number or address listed above to let us know the billed charges are higher than the Good Faith Estimate.
- You can ask us to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
- You may also start a dispute resolution process with the U.S. Department of Health and Human Services within 120 calendar days (about 4 months) of the date on the original bill.
- There is a $25 fee to use the dispute process.
- If the reviewing agency agree with you, you will only need to pay the amount on the Good Faith Estimate.
- If the agency disagrees with you, you will have to pay the higher amount. To learn more and get a form to start the process, go to www.cms.gov/nosurprises.