Your Right to a Good Faith Estimate

Under the No Surprises Act, health care providers need to give uninsured and self-pay individuals an estimate of expected charges 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.

• We will provide you a Good Faith Estimate in writing before your scheduled service or item, or upon your request.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can 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.