Good Faith Estimate

You have the right to receive a Good Faith Estimate


A Good Faith Estimate (GFE) is intended to create transparency with health care providers about the cost associated with receiving services.

Consumer Rights

Individuals who do not have insurance or are not using their insurance for services are entitled to a GFE.



You have the right to receive a GFE for the total expected cost of any non-emergency items or services.  This included related costs such as assessments, extra fees, or supplemental supplies.



You are entitled to receive a GFE in writing at least one day before your appointment. You can also ask your provider, and any other provider you choose, for a GFE before you schedule any services.



If you receive a bill that is at least $400 more than your GFE, you can dispute the bill.



The GFE is not is not a contract and does not obligate you to obtain any services from the provider listed, nor does it include any services rendered to you that are not identified in the estimate.



Consumers are encouraged to save a copy or picture of your GFE.



You are encouraged to talk to your provider at any time about questions you may have regarding the GFE.



For questions or more information about your rights to a GFE visit:


www.cms.gov/nosurprises

or

Call  1 - 800 - 985 - 3059


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