Good Faith Estimate, and No Surprises Act

You have the right to receive a “Good Faith Estimate” estimating how much your 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 your first session.

You can also ask your health care provider, and any other provider you

choose, for a Good Faith Estimate before you schedule a

service.

• You can also receive information regarding the No Surprises Act from your provider.  This is for clients whose insurance is out of network with Dr. Dinehart.

• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information visit www.cms.gov/nosurprises, or call the Arizona Department of Insurance and Financial Institutions at 602-364-3100.