Good Faith Estimate Notice

Under Section 2799B-6 of the Public Health Service Act, health care providers need to give clients who do not have health insurance or who are not using health insurance an estimate of the expected charges for medical services, including therapy services.

You have the right to receive a “Good Faith Estimate” explaining the total expected cost of any non-emergency healthcare services. This includes related costs like therapy services, medical tests, prescription drugs, equipment, and hospital fees.

You can ask your health care provider and any other provider you choose, for a Good Faith Estimate in writing before you schedule a service or at least 1 business day before your scheduled service, or at any time during treatment.

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.