YOUR RIGHT TO A GOOD FAITH ESTIMATE

Under Section 2799B-6 of the Public Health Service Act and the federal No Surprises Act, healthcare providers are required to inform individuals who are not enrolled in an insurance plan or who are not using insurance a "Good Faith Estimate" of expected charges 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, including psychotherapy services.

• You have the right to receive a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare 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.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.