Good Faith Estimate

Notice of Good Faith Estimate 

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost. Under federal law (Section 2799B-6 of the Public Health Service Act, known as the “No Surprises Act”), health care providers must provide patients who do not have health insurance coverage or who are not using health coverage (self-pay) an estimate of the costs of services before those services are provided. 

You have the right to receive a Good Faith Estimate (GFE) of costs associated with your anticipated care. 

• If you schedule care 10 days or more in advance, you are entitled to a GFE within three (3) business days. 

• If you schedule care 3-9 business days in advance, you are entitled to a GFE within one (1) business day. 

If you receive a bill that is at least $400 more than your Good Faith Estimate from that provider or facility, you can dispute 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.