Good Faith Estimate of Expected Charges Under the No Surprises Act
(HR133, Title 45 Section 149.610)

You have the right to receive a Good Faith Estimate explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of charges for billed medical items and services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. Upon request, your provider will provide you with a Good Faith Estimate in writing at least one (1) business day before your medical service or item. You can also request a Good Faith Estimate before you schedule an item or service. 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. For questions or more information about your right to a Good Faith Estimate, visit: www.cms.gov/nosurprises.