Good Faith Estimate & the No Surprises Act (HR 133)

Under the No Surprises Act (H.R. 133 ), health care providers need to give clients or patients who do not have insurance or who are not using insurance an estimate of the bill for services.

  • This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs. The estimate is based on information known at the time the estimate was created.

  • The Good Faith Estimate does not include any unknown or unexpected costs that may arise in the course of the services. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute or appeal the bill.

  • If you receive an invoice that is at least $400 more than your Good Faith Estimate, you can dispute or negotiate the bill. You may contact our office at 650-691-8978 and ask to (1) update the bill to match the Good Faith Estimate, (2) negotiate the invoice, (3) inquire about financial assistance, or (4) propose a payment plan. 

  • You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. To learn more and get a form to start the process, visit: www.cms.gov/nosurprises or call CMS at 1-800-985-3059.

  • This GFE is not a contract. It does not obligate you to accept the services described in it.

Request a Good Faith Estimate

  • When scheduling services, make sure your provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your provider for a Good Faith Estimate before you schedule an item or service.​
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Note: A Good Faith Estimate is for your awareness only.
It does NOT involve you needing to make any type of commitment.

Learn More...

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

For future reference,  keep a copy of your Good Faith Estimate in a safe place, download it, or take pictures of it. 

This information is provided in compliance with HR 133. Please contact me to request an estimate or if you have any specific questions regarding your evaluation.