MOORE COUNTY THERAPY GOOD FAITH ESTIMATE

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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. 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.
• Providers cannot balance bill a patient unless patient was notified prior to services and signed an agreed upon consent to waive protections.
• Any State laws supersede Federal protections against balance billing.

Listed below is contact information for individuals who feel a facility or provider has violated the state of federal requirements against balance billing.

For questions or more information about your right to a Good Faith Estimate, visit (if your State does not have guidelines relating to No Surprises Billing, contact the Department of Health and Human Services)

Department of Health and Human Services: www.cms.gov/nosurprises or 877-696-6775

Texas: https://www.tdi.texas.gov/medical-billing/surprise-balance-billing.html or 800-252-3439