NO SURPRISES ACT

Your Right to a Good Faith Estimate

Under the federal No Surprises Act, health care providers must give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment and hospital fees.
  • Make sure your health care 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 health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

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

Good Faith Estimates at Excelsior & Grand

This applies when you don’t have insurance or choose not to use insurance for a service, such as self-pay chiropractic or wellness visits, Class 4 laser therapy, Graston Technique® or massage. To request a Good Faith Estimate, or if you have questions about one you received, contact our office: