Your Right to a Good Faith Estimate

Under the federal No Surprises Act, healthcare providers must give patients who don’t have insurance, or who are not using insurance, an estimate of expected charges before treatment.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services, including related costs like counseling sessions or psychological evaluations.
• You can ask your provider, or any healthcare provider you choose, for a Good Faith Estimate before you schedule a service, or any time you request it.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
• Keep a copy of your Good Faith Estimate in a safe place for future reference.

Requesting Your Estimate

To request a Good Faith Estimate, contact us at (501) 382-1816 before scheduling services.

More Information

For more information about your rights under the No Surprises Act, visit www.cms.gov/nosurprises or call 1-800-985-3059.