Good Faith Estimate

Under the “No Surprises Act” effective January 1,2022, you are entitled to a Good Faith Estimate (GFE), which aims to provide you with accurate information regarding the expected cost of out of network healthcare services. Healthcare providers are required to provide a GFE of expected charges for scheduled or requested services at least three business days before the appointment if the service is scheduled or no later than three business days after the date of request if the patient requests a GFE without scheduling the services.

The Good Faith Estimate does not include any unknown or unexpected costs of treatment.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059.