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Good Faith Estimate

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

This law does not apply to urgent care or emergency services. We are unable to provide Good Faith Estimates for urgent care services. Please read more here: www.cms.gov/nosurprises.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

To obtain a Good Faith Estimate, please complete this form. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.