Good Faith Estimate Policy

ABOUT YOUR RIGHT TO RECEIVE A GOOD FAITH ESTIMATE OF EXPECTED CHARGES

Under the law, health care providers need to give patients who don’t have insurance or who are not using 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.

• You may ensure that health care provider gives you a Good Faith Estimate in writing at least 1 business day before your therapy services or item. You can also ask your health care provider for a Good Faith Estimate prior to scheduling.

• If you receive a bill that is $400 more than your Good Faith Estimate, you can dispute the bill.

• It's recommended that you save a copy of your Good Faith Estimate for your records.

For further information, visit www.cms.gov/nosurprises or call 800-985-3059.