No Surprises Act / Good Faith Estimate Notice

Under Section 2799B-6 of the Public Health Service Act, health care providers and facilities must inform individuals who are not enrolled in a health plan or Federal health care program, or who are not submitting a claim to their coverage, that they may receive, upon request or at the time of scheduling, a written and oral Good Faith Estimate of expected charges for health care items and services.

You have the right to receive a Good Faith Estimate of the total expected cost of any non-emergency items or services, including related costs such as medical tests, prescription drugs, equipment, and hospital fees.

Your health care provider must give you a written Good Faith Estimate at least 1 business day before your scheduled service or item. You may also request a Good Faith Estimate from your provider, or any other provider you choose, before scheduling.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.

For questions or more information about your right to a Good Faith Estimate, visit http://www.cms.gov/nosurprises.