COST INFORMATION
Your right to a Good Faith Estimate
Eligible uninsured or self-pay patients have the right to receive a written estimate of expected healthcare charges.
When an estimate is available
Under the federal No Surprises Act, patients who are uninsured or do not intend to use their insurance for the relevant care may be entitled to a Good Faith Estimate. Government-program coverage can affect eligibility for this particular process. Ask about your situation before care begins.
Requesting or scheduling care
Eligible patients also receive an estimate when care is scheduled at least three business days in advance; no separate request is required. You can request an estimate before scheduling; it is generally due within three business days of the request. For eligible care scheduled three to nine business days ahead, the estimate is due within one business day after scheduling; for care scheduled at least ten business days ahead, within three business days after scheduling.
What to check
Review the expected charges, the services described, and any assumptions in the estimate. Your estimate should reflect the agreed format: $200 for a standard first month or $500 for a comprehensive first month, then $200 for each later month included in the estimate. The first month starts with payment and includes the agreed preparatory work. Ask which outside charges require information from another provider. Keep a copy of the estimate.
If a bill is at least $400 higher
If charges from a provider or facility are at least $400 above that provider's or facility's Good Faith Estimate, you may be eligible for the federal patient–provider dispute resolution process. The process generally must be started within 120 calendar days of receiving the initial bill. See CMS for current instructions and eligibility.
Questions and official guidance
You can request a Good Faith Estimate from the practice before scheduling care. Official federal guidance is available on the CMS website.