Notice of Good Faith Estimates

Under the law, if you do not have medical insurance or choose to not utilize your medical insurance for specific episodes of care provided, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like office visits, medical tests, and medical equipment
• If you request one, a Good Faith Estimate must be provided in writing at least 3 business days from the time an appointment is scheduled for the service. If the appointment is scheduled 10 or more days away, the estimate must be provided at least three days after the appointment is scheduled. In the event the care is emergent or testing is recommended during an office visit, your GFE will be provided at the time your additional services are
  offered.
• You can ask your health care provider for a Good Faith Estimate before you schedule an item or service although this will be just an estimate as the exact care you need cannot be determined until your doctor evaluates you.
• 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