Good Faith Estimate Notice
You have the right to receive a “Good Faith Estimate” explaining how much your medical care and mental health care will cost.
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, including psychotherapy services; other examples include medical tests, prescription drugs, equipment, and hospital fees.
You can ask your health care provider to give you a Good Faith Estimate in writing at least one business day before your scheduled services. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a health care 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 to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.