GOOD FAITH ESTIMATE FOR UNINSURED OR SELF-PAY PATIENTS

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the No Surprises Act, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill 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. You can ask your health care provider for a Good Faith Estimate upon scheduling a service or upon request. If there are any anticipated changes to a Good Faith Estimate that you have received, such as any changes in charges, services, or changes in the frequency or duration of those services, your provider will provide a new Good Faith Estimate to you.

If you receive a bill that is substantially higher than your Good Faith Estimate, you can dispute the charges. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.