Your Right to Receive a Good Faith Estimate

Under the No Surprises Act, individuals who do not have health insurance or who are choosing not to use their health insurance to pay for services have the right to receive a Good Faith Estimate of the expected cost of their care.

If you schedule a service at least 3 business days in advance, you are entitled to receive a Good Faith Estimate in writing. You may also request a Good Faith Estimate at any time before scheduling services.

If you schedule services:

• 3–9 business days in advance: the Good Faith Estimate must generally be provided within 1 business day after scheduling.

• 10 or more business days in advance: the Good Faith Estimate must generally be provided within 3 business days after scheduling.

• Before scheduling: if you request an estimate, it must generally be provided within 3 business days of your request.

The Good Faith Estimate will include the expected charges for the services reasonably expected to be provided.

If you receive a bill that is $400 or more above the Good Faith Estimate from a provider or facility, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process.

For more information about your right to a Good Faith Estimate or the dispute resolution process, visit CMS at https://www.cms.gov/nosurprises/consumers or call 1-800-985-3059.