As of January 1, 2022, under the No Surprises Act (H.R. 133), healthcare providers are obligated to provide clients or patients without insurance or not using insurance with an estimate of the bill for medical items and services.

This document, known as the Good Faith Estimate (GFE), offers a transparent breakdown of the expected costs for the healthcare items and services you require. It’s your right to receive a GFE for the total anticipated expense of non-emergency items or services.

However, please note that the GFE does not account for unforeseen or unexpected costs that could arise during your treatment. Additional charges might occur due to complications or unique circumstances.

Should you receive a bill exceeding $400 more than your GFE, you have the right to dispute or appeal the bill. You can get in touch with the listed healthcare provider or facility to inform them that the billed charges surpass the GFE. You can request them to adjust the bill to align with the GFE, negotiate the bill, or inquire about available financial assistance.

In the event of disagreement, you have the option to initiate a dispute resolution process with the U.S. Department of Health and Human Services (HHS). This process must be initiated within 120 calendar days (approximately four months) from the original bill’s date. A $25 fee applies for using the dispute process. If the agency reviewing your dispute sides with you, you’ll be charged the amount on this GFE. Conversely, if they side with the healthcare provider, you’ll need to pay the higher amount.

To ensure your awareness and understanding, healthcare providers must furnish you with a GFE within specific timeframes:

  • If the service is scheduled at least three business days before the appointment, no later than one business day after scheduling.
  • If the service is scheduled at least ten business days before the appointment, no later than three business days after scheduling.
  • If an uninsured or self-pay client requests a GFE (without scheduling the service), no later than three business days after the request.

Please remember that a Good Faith Estimate does not necessitate immediate financial commitment or payment. For more information and inquiries about your entitlement to a GFE or the dispute process, visit No Surprises Act or call 800-985-3059. Keep a copy of this GFE in a secure place or take photos of it, as it may be needed if you receive a higher bill amount.

Should you have any questions or concerns, please don’t hesitate to reach out. Your well-being and understanding are important to us.