Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.

Under the law, health care providers need to give patients who don’t have certain types of health care coverage — or who are not using certain types of health care coverage — an estimate of their bill for health care items and services before those items or services are provided.

• You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling. This includes related costs like medical tests, prescription drugs, equipment, and facility fees.
• If you schedule an item or service at least 3 business days in advance, your provider must give you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule at least 10 business days in advance, you must receive it within 3 business days. You can also ask any provider or facility for a Good Faith Estimate before you schedule; if you do, you must receive it in writing within 3 business days.
• If you receive a bill that is at least $400 more than your Good Faith Estimate from that provider or facility, you can dispute the bill.

If You Receive a Bill Higher Than Your Estimate

This Good Faith Estimate shows the costs of items and services reasonably expected for your health care needs. The estimate is based on information known at the time it was created. It is not a contract, and you are not obligated to receive the care described in it.

If you receive a bill that is $400 or more above your Good Faith Estimate, federal law allows you to dispute it. You may ask us to update your bill to match the Good Faith Estimate, ask us to negotiate the amount, or ask whether financial assistance is available. To dispute a bill, please contact our Patient Advocacy team [PENDING CONFIRMATION] at (954) 735-3535.

You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to do so, you must start the process within 120 calendar days of the date on the original bill. There is a $25 fee to use the HHS dispute process. If the Selected Dispute Resolution (SDR) entity agrees with you, you will pay the price on this Good Faith Estimate; if it agrees the bill is correct, you will pay that amount.

Questions & More Information

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059. Keep a copy of your Good Faith Estimate in a safe place or take pictures of it — you will need it to file a dispute in the future.