You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.
Under the law, health care providers need to give patients who don’t have certain types of health care coverage, or who are not using certain types of health care coverage, an estimate of their bill for health care items and services before those items or services are provided.
If you are uninsured, or you are insured but not planning to file a claim for this care, this applies to you.
What you are entitled to
You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request, or when scheduling such items or services. This includes related costs like medical tests, equipment, and facility fees.
If you schedule an item or service at least 3 business days in advance, we must give you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule at least 10 business days in advance, we must give it to you in writing within 3 business days after scheduling. You can also ask for a Good Faith Estimate before you schedule anything at all — if you do, we must give it to you in writing within 3 business days after you ask.
Make sure to save a copy or picture of your Good Faith Estimate.
If your bill is higher than your estimate
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill through the federal patient-provider dispute resolution process. You have 120 calendar days from the date on the bill to start that process.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
How to ask us for one
Call or text 220-246-9283 and say you would like a Good Faith Estimate. Tell us what you are considering — an assessment, a course of nerve treatment, shockwave, laser — and we will put the expected charges in writing and send them to you.
You can ask before you book. You do not need to be a patient, and asking does not commit you to anything.
What an estimate is and is not
A Good Faith Estimate shows the costs of items and services that are reasonably expected for your care. It is based on what is known at the time it is made. It does not include unknown or unexpected costs that come up if something about your care changes — for example, if an assessment finds that a different treatment plan is the right one.
A Good Faith Estimate is not a contract. It does not require you to receive any of the items or services listed on it.