Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t 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 that are reasonably expected at the time of scheduling. This
  includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• For patients who don’t have insurance or who are not using insurance, Rockbridge Area Health Center (RAHC) will provide a Good Faith Estimate of scheduled services in writing at least 1 business day before the medical service or item.
• You can also ask RAHC, 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 https://www.cms.gov/nosurprises/ or call the federal surprise billing hotline at 1- 800-985-3059.

This notice is not intended to be a full summary of the No Surprises Act. It is intended only to be a general information summary of technical legal standards. Complete and current information is available at: https://www.cms.gov/nosurprises/Policies-and-Resources/Overview-of-rules-fact-sheets