Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your medical care will cost.

Under the No Surprises Act, health care providers must give patients who are uninsured, or who are insured but not using their insurance, a written estimate of the expected charges for non-emergency care.

This means:

• You have the right to receive a Good Faith Estimate of the total expected cost of any non-emergency items or services, including psychiatric evaluation, ongoing medication management, therapy, and interventional treatments.
• You can ask for an estimate at any time, including before you schedule anything. We will give it to you in writing within three business days of your request.
• If you schedule non-emergency care in advance, you will receive an estimate without having to ask: within one business day when you schedule at least three business days ahead, and within three business days when you schedule at least ten business days ahead.
• 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. Disputing a bill will not affect the care you receive here.
• An estimate is not a bill and not a contract. It does not commit you to booking the care it describes.
• Keep a copy of your Good Faith Estimate.

This notice applies to self-pay care. If you are using insurance, your costs are governed by your plan rather than by a Good Faith Estimate. See our Insurance page or ask our billing staff.

To ask for an estimate, call us or tell our staff when you get in touch that you plan to pay without using insurance.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.