Good Faith Estimate

Good Faith Estimate Notice

Under the No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining the expected cost of your medical and mental health care.

You have the right to request a Good Faith Estimate before scheduling services. This estimate is provided for informational purposes only and does not obligate you to begin or continue services.

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

Make sure to save a copy or picture of your Good Faith Estimate.

For more information about your rights under the No Surprises Act and Good Faith Estimates, please visit www.cms.gov/nosurprises.