On September 30, 2021, the United States Department of Health and Human Services (HHS) released it’s second Interim Final Rule to protect consumers from surprise medical bills, implementing the “No Surprises ACT” enacted in December 2020. This IFR establishes a requirement for health care providers to provide *uninsured and self-pay patients *with a Good Faith Estimate of their total out-of-pocket cost for services upon request, or after they schedule an appointment (provided that it was scheduled at least 3 days in advance.)
The Good Faith Estimate is only an estimate and shows the cost of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time that the estimate is created. While caring for you, our providers may recommend additional services that are not listed in your Good Faith Estimate resulting in your actual charges to vary from the Good Faith Estimate.
If your actual charges are more than $400 above the estimate, you have the right to dispute the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can inquire about payment plans or if there is any other financial assistance available.
You may also start a dispute resolution process with the 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 the Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider, you will have to pay the higher amount. To learn more and get a form to start the process, go to cms.gov/nosurprises/consumers or call 1-800-985-3059.