Good Faith estimate

---

Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical services. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services.

• Make sure your health care provider gives you a Good      Faith Estimate in writing at least 1 business day before your medical service. You can also ask your health care provider for a Good Faith      Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.
• This is just an estimate and as your therapist gathers more information about your symptoms and severity, your Good Faith Estimate may be revised to reflect this new information. Any time your Good Faith Estimate is revised it will be updated and provided to you.
• You have the right to request an updated Good Faith Estimate at any time in your treatment. ​

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the Federal No Surprises Help Desk at 1-800-985-3059.