Angela D. Mathew, LMFT, MA
No Surprises Act
No Surprises Act
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
• 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 such items or
services. This includes related costs like medical tests, prescription drugs,
equipment, and hospital fees.
• If you schedule a health care item or service at least 3 business days in advance,
make sure your health care provider or facility gives you a Good Faith Estimate in
writing within 1 business day after scheduling. If you schedule a health care item or
service at least 10 business days in advance, make sure your health care provider
or facility gives you a Good Faith Estimate in writing within 3 business days after
scheduling. You can also ask any health care provider or facility for a Good Faith
Estimate before you schedule an item or service. If you do, make sure the health
care provider or facility gives you a Good Faith Estimate in writing within 3
business days after you ask.
• If you receive a bill that is at least $400 more for any provider or facility than your
Good Faith Estimate from that provider or facility, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate and the bill.
For questions or more information about your right to a Good Faith Estimate, visit
www.cms.gov/nosurprises/consumers, email [email protected], or call 1-