Good Faith Estimate
You have a right to know
You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the bill for services.
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services.
• At your request, Orange Therapy staff will provide a Good Faith Estimate in writing at least one business day before your appointment. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an appointment.
• 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 www.cms.gov/nosurprises or call 1-800-985-3059.