Right to Receive a Good Faith Estimate of Expected Charges

Under the No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Any patient that does not have insurance or does not intend to use insurance for their care will be provided an estimate of the bill for their medical care. Uninsured and self-pay individuals also have the right to proactively request a good faith estimate before scheduling.

What is included?

The Good Faith Estimate consists of an itemized list of expected charges for each item or service reasonably expected to be provided  with the primary item or service. This includes items or services that may be provided by other providers or facilities. The expected charges will be grouped by each provider or facility offering care.

For example, the good faith estimate for surgery might include the cost of the surgery (both the facility and the physician fee), labs or tests, and any anesthesia used during the operation.

When will I receive my Good Faith Estimate?

• Within one business day after scheduling when the primary item or service is scheduled at least three business days in advance.
• Within three business days after scheduling when the primary item or service is scheduled at least 10 business days in advance.
• Within three business days after being requested by an uninsured or self-pay consumer who has not yet scheduled.

You will be provided an electronic copy of the Good Faith Estimate even if the information was provided verbally. Make sure to save a copy of your Good Faith Estimate.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.