fees and health insurance

Under the No Surprises Act (H.R. 133 – effective January 1, 2022), health care providers need to give clients or patients who do not have insurance or who are choosing not to use insurance an estimate of the bill for items and services. This is in addition to your Disclosure Statement you also receive. 

You have the right to receive a GFE for the total expected cost of any non-emergency items or services. If you receive a bill at least $400 more than your GFE, you may dispute or appeal the bill.

You may contact the health care provider or facility listed to let them know the billed charges are higher than the GFE. You may ask them to update the bill to match the GFE, negotiate the bill, or ask if financial assistance is available.

Make sure your health care provider gives you a GFE within the following timeframes:

If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling; 

If the service is scheduled at least ten business days before the appointment date, no later than three business days after the date of schedule; or

If the uninsured or self-pay client requests a GFE (without scheduling the service), no later than three business days after the date of the request. Healthcare providers must supply a new GFE within the specified timeframes if the patient reschedules the requested item or service.

Note: A Good Faith Estimate is for your awareness only and does not require immediate financial commitment or payment. 

To learn more, go to www.cms.gov/nosurprises or call 800-985-3059. 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.