Good Faith Estimate

Under the No Surprise Act (H.R. 133- which went into effect on January 1, 2022), health care providers need to give clients or patients who do not have insurance of who choose to seek services outside of their insurance providers (not utilize their insurance) with an estimate of the bill for medical items or services.

  • This Good Faith Estimate shows the cost 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.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services.

  • The Good Faith Estimate 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.

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

  • Make sure that your health care provider gives you a Good Faith Estimate within the following timeframes:

    • If service is scheduled at least 3 business days before the appointment date, no later than one business day after the date of scheduling.

    • If the service is scheduled at least 10 business days before the appointment date, no later than 3 business days after the date of scheduling, or:

    • If the uninsured or self-pay client/patient requests Good Faith Estimate (without scheduling the service), no later than 3 business days after the date of request.

  • The No Surprise Act has a universal waiver required.

  • This is the public disclosure of the “Good Faith Estimate”

Note: A Good Faith Estimate is for your awareness only. It does not involve you needing to make any type of commitment.

To learn more and get a for to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions of more information about your Good Faith Estimate or the dispute process visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of your Good Faith Estimate for your knowledge and in case of needing to file a dispute.

If you have any questions or concerns, please feel free to reach out.