Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act and its implementing regulations, health care providers and facilities are required to inform individuals who are not enrolled in a group health plan, group or individual health insurance coverage, a Federal health care program, or a Federal Employees Health Benefits (FEHB) program (uninsured individuals), or who are not seeking to file a claim with their group health plan, health insurance coverage, or FEHB plan (self-pay individuals), in writing (and orally if requested), of their right to receive a "Good Faith Estimate" of expected charges.

You Have the Right to Receive a "Good Faith Estimate" Explaining the Cost of Your Health Care

Under the law, health care providers must provide patients who don't have certain types of health coverage, or who are not using health coverage, with an estimate of the bill for health care items and services before those items or services are provided.

• You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling them. This includes costs such as medical tests, prescription drugs, equipment, and hospital fees.
• If you schedule a health care item or service at least 3 business days in advance, your health care provider or facility must give you a Good Faith Estimate in writing within 1 business day of scheduling. If you schedule a health care item or service at least 10 business days in advance, your health care provider or facility must provide a Good Faith Estimate in writing within 3 business days of scheduling. You may also request a Good Faith Estimate before scheduling an item or service. If requested, the provider or facility must provide the estimate in writing within 3 business days.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Be sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.