Your Right to a Good Faith Estimate

Under a federal law called the "No Surprises Act," you have the right to receive a "Good Faith Estimate" for the total expected cost of any non-emergency medical items and services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

What this means for you:

• You have the right to receive a Good Faith Estimate for the expected cost of our services before you schedule an appointment.
• We will provide you with a written Good Faith Estimate at least 1 business day before your scheduled service. You can also ask us for an estimate before you schedule an 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 your records.

Disclaimer

The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. It does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the U.S. Department of Health and Human Services at 1-800-985-3059.