Good Faith Estimate
Good Faith Estimate for Health Care Services Under the No Surprises Act
The No Surprises Act is in effect to protect clients from receiving unexpected medical bills. The Good Faith Estimate provision of the No Surprises Act is created to give clients an estimate of how much they will be charged for the healthcare services they will be receiving, prior to their appointment. Health care providers are required to provide a good faith estimate of expected charges for services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage (self-pay). The good faith estimate is a notification of expected charges for a scheduled or requested service (or item). The “expected charge” for an item or service is either: a) the cash pay rate or rate established by a provider for an uninsured (or self-pay) client; or b) the amount the provider would expect to charge if the provider intended to bill a health care plan directly for such item or service. This notice is to be provided both orally and in writing, upon request or at the time of scheduling health care services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services. This includes costs such as medical tests, prescription drugs, equipment, and hospital fees. A good faith estimate must be provided within 3 business days upon request. 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 http://www.cms.gov/nosurprises or call 800-985-3059.