Good Faith Statement

Notice

The following is a notice that complies with the No Surprises Act effective January 1, 2022. 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 an estimate of the bill for medical items and services to patients who don’t have insurance or who are not using insurance.

• 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.
• A Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
• A Good Faith Estimate will not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

For questions or for more information about your right to a Good Faith Estimate, please visit www.cms.gov/nosurprises