You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under state and federal law, a patient may ask a health care provider for a Good Faith Estimate of the price the health care provider and health facility will charge for providing a non-emergency health care service, including costs such as medical tests, prescription drugs, equipment, and hospital fees. The Good Faith Estimate will be made in writing and provided within the timeframes stated in this notice.
- Any Patient. Any patient (insured, uninsured, or self-pay) may request a Good Faith Estimate of expected charges for non-emergency health care services. When one is requested, you will be provided a copy of this Good Faith Estimate within 3 business days of the request (when uninsured or self-pay) and 5 business days (when insured).
- Uninsured Patients. Federal law requires health care providers to give you a Good Faith Estimate in advance of scheduling or upon request if you are uninsured or self-pay (not using your insurance to pay for the item or service). The Good Faith Estimate will be provided within 3 business days of scheduling the non-emergency health care service or within 1 business day if the non-emergency health care service is scheduled to be performed by the practitioner within 3 business days.
You may ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
Patients who are uninsured or self-pay may dispute the actual charges if they exceed the Good Faith Estimate by at least $400.00.