Your right to a Good Faith Estimate

If you are uninsured or are not using insurance to pay for care, you have the right to a written Good Faith Estimate of the total expected cost of your health care items and services.

• For care scheduled 3 to 9 business days ahead, the estimate is due within 1 business day after scheduling.

• For care scheduled 10 or more business days ahead, the estimate is due within 3 business days after scheduling.

• You can request an estimate before scheduling. It is due within 3 business days after your request.

• If a provider’s bill is at least $400 above that provider’s estimate, you may dispute it.

Keep a copy of your estimate. To request one, email Kelly or call 832-900-0653.

For more information, visit CMS No Surprises: Information for consumers or call 1-800-985-3059.