You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under a federal law (the “No Surprises Act”) taking effect on January 1, 2022, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of expected charges 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 my collaboration with other providers in the context of your treatment, preparation of documents for court, late-cancel fees, and other billable items. You may request that I give you a Good Faith Estimate in writing at least one business day before your medical service or related item. You can also ask me, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. This Good Faith Estimate must be in a format that you can save and print. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or contact me by phone or email.

Jacob Donnelly, LCSW #63900 • (510) 982-6836• jacoblcsw@gmail.com