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What You Should Know about “Good Faith” Cost Estimates for Uninsured or Self-Pay Patients
If you do not have health insurance, or if you do not plan to use your insurance to pay for a medical item or service, you are considered to be an “uninsured” or “self-pay” patient. In this situation, before you receive the medical item or service, a health care provider or facility (such as Agrace) must give you a “good faith” cost estimate, with details of how much you may be charged.
The good faith estimate will include these items:
The good faith estimate will also tell you how to dispute (reject) your bill, while the amount is investigated. If you get a bill that is at least $400 more for any provider or facility than the total expected charges shown for that provider or facility on the good faith estimate, you can use a patient-provider dispute resolution (PPDR) process. It’s through the U.S. Department of Health and Human Services (HHS).
To start the patient-provider dispute resolution process, call (800) 985-3059 or go to cms.gov/nosurprises/consumers.
Agrace cannot take or threaten to take any punitive (punishing) action against you for disputing your bill.
Here are more details about the Department of Health and Human Services patient-provider dispute resolution process.
Questions about good faith estimates may be directed to Jennifer Flugaur, Agrace’s vice president of clinical excellence: (608) 327-7291 or firstname.lastname@example.org