Standard notice: “Right to Receive a Good Faith Estimate of Expected Charges” under the No Surprises Act
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. This includes related costs like medical tests, prescription drugs, equipment and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, 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.
When the estimate arrives
If you schedule an item or service at least three business days in advance, you will receive a Good Faith Estimate in writing within one business day of scheduling. If you schedule at least ten business days in advance, you will receive it within three business days. If you ask for an estimate without scheduling anything, you will receive it in writing within three business days of asking.
Disputing a bill
If the bill you receive is $400 or more above the Good Faith Estimate you were given, you may start the federal patient-provider dispute resolution process. You have 120 calendar days from the date on the bill to start it, and you will need your copy of the estimate.
Asking us for an estimate
To request a Good Faith Estimate from Khristian Durham Counseling, email khrisdurhamcounseling@gmail.com or call (323) 376-9774. You can ask before you schedule anything.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.