Good Faith Estimate Notice
- You have the right to receive a “Good Faith Estimate”
- explaining how much your medical and mental health 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 the expected charges for medical services,
- including psychotherapy services.
- You have the right to receive a Good Faith Estimate for the
- total expected cost of any non-emergency healthcare
- services, including psychotherapy services.
- You can ask your health care provider, and any other provider
- you choose, for a Good Faith Estimate before you schedule a
- 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 or call (800)
- 985-3059.