NO SURPRISE ACT NOTICE

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

Under the law, health care providers need to give patients who don’t have insurance or who are electing to not use their insurance a cost estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes   related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Your health care provider must give you a Good Faith Estimate in writing for scheduled services within designated timeframes. 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.