Good Faith Estimate

Pursuant to the No Surprises Act (HR133, Title 45 Section 149.610), health care providers need to give clients who don’t have insurance or who are not using insurance a “Good Faith Estimate” of expected charges for services to be provided. 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. This provider is not in your health plan’s network and does not have an agreement with your insurance plan. Getting care from this provider could cost you more. You may wish to contact your health plan to determine if your plan will contribute toward out-of-network services. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Initiating the dispute process will not adversely affect the quality of services rendered to you. You may contact the provider to let them know the billed charges are higher than the GFE. You can ask them to update the bill to match the GFE or ask to negotiate the bill.  You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS) by calling (800) 368-1019 or going to  www.cms.gov/nosurprises. A dispute process must be begun within 120 calendar days (about 4 months) of the date on the original bill and there is a $25 fee. The GFE will be a part of your medical record and you may wish to keep a copy for yourself. You are encouraged to speak with your provider at any time about questions you may have.