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No Surprises Act Notice

Effective January 1, 2022, uninsured or self-pay patients have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost  at our health centers.

Under the law, health care providers need to give uninsured (patients who do not have insurance) or self-pay (patients who are not submitting the claim to their health insurance carrier) an estimate of the bill for medical services or items.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services or items. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Ensure your health care provider gives you a Good Faith Estimate in writing for scheduled services within the designated time-frames. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than the Good Faith Estimate, you can dispute the bill.

Make sure to save a copy of the Good Faith Estimate for your records.If you have additional questions, please visit: www.cms.gov/nosurprises or call the no surprises help desk number displayed below.

1-800-985-3059 between 8AM – 8PM est.

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