Under the law, 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. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

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As such, I will provide you with a good faith estimate of expected charges for services at your request or at the time of scheduling. I will provide this estimate in writing, to be updated or renewed each year or when there are changes in expected fees. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

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Make sure to save a copy or picture of your Good Faith Estimate. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.​ For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.