Notice: Good Faith Estimate

The Surprise Billing Law requires health care providers to provide patients who do not have insurance or are not using insurance, a “Good Faith Estimate” of expected charges before receiving health care items or services when requested

  • You have the right to request and receive a Good Faith Estimate for the total expected cost of any non-emergent health care items or services. This includes related costs like medical tests, prescription drug, equipment, and hospital fees.
  • We will be happy to provide you with a Good Faith Estimate in writing, paper or electronic, upon request at least one business day or more, in accordance with the law, before your medical service or item. You can also ask us, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that exceeds your Good Faith Estimate by more than $400, you can dispute the bill. There is $25 administrative fee to process a dispute.

For questions or more information about your right to a Good Faith Estimate, visit,
or email 
or call 1-800-985-3059