Good Faith Estimate

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 not using insurance an 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 that are reasonably expected at the time of scheduling. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• For patients who don’t have insurance or who are not using insurance, PCHC will provide a Good Faith Estimate of scheduled services in writing at least 1 business day before the medical service or item.
• You can also ask PCHC, and any other provider you choose, 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.
• For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises\ or call 1-800-985-3059.
• This notice is not intended to be a full summary of the No Surprises Act. It is intended only to be a general information summary of technical legal standards. Readers should refer to the applicable statutes, regulations and other interpretive materials and complete and current information. See here: https://www.cms.gov/nosurprises/Policies-and-Resources/Overview-of-rules-fact-sheets