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CMS-10791: Right to Receive a Good Faith Estimate

Link to Form: https://parma.trustinsurance.com/Portals/0/documents/Right%20to%20Receive%20a%20Good%20Faith%20Estimate%20of%20Expected%20Charges.pdf?ver=XZA9UFb6pFaMD2oU0kJIXA%3d%3d×tamp=1641321131436

  • 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. 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.