• 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, equipment, and clinic fees.
• You should receive your estimate in writing at least 1 business day before your scheduled service.
• You may also ask us for a Good Faith Estimate before you schedule a service.

• The estimate will explain the expected costs of your care.
• Your actual charges may differ if your treatment changes, but we will discuss any adjustments with you.
• Keep a copy of your Good Faith Estimate. If your bill is at least $400 more than your estimate, you may dispute the bill.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute it:

1. Contact us first so we can review the bill together.
2. You may also start a dispute resolution process with the U.S. Department of Health & Human Services (HHS).
3. To learn more or get forms to start the process, visit: www.cms.gov/nosurprises