Good Faith Estimate

You may have the right to receive a “Good Faith Estimate” explaining how much your health care will cost

If you are uninsured, or you do not wish to submit a bill for your care to your insurance plan for your care, then you have a right to receive an estimate of your bill before receiving any health care items or services.

• When scheduling your appointment, we will ask you if you have insurance or how you wish to pay. If you do not have insurance, or if you wish to pay on your own without insurance, then you will be given a good faith estimate for the costs of the services we anticipate providing to you.
• The estimate will include the total expected cost for all items or services that we reasonably expect to provide to you at the time of scheduling.
• If you schedule at least 10 days in advance, we will deliver a good faith estimate to you within 3 days of scheduling. If you schedule at least 3 days in advance, we will deliver a good faith estimate to you within 1 day of scheduling. If you schedule less than 3 days in advance, you may not receive a good faith estimate prior to your appointment.
• You may also request an estimate at any time. We will return a good faith estimate within 3 days of your request.
• Make sure to save a copy or picture of your estimate and the bill.
• If you receive a bill that is at least $400 more than your estimate, you can dispute the bill by visiting www.cms.gov/nosurprises/consumers.