Good Faith Estimate Information

What to know as an uninsured or self-pay patient

Tell the clinic if you do not have insurance or do not intend to use it, and ask for a Good Faith Estimate in writing before care. CMS states that, in most cases, a provider must give an estimate when care is scheduled at least three business days in advance or when the patient requests one.

The estimate should describe the expected charges for the anticipated items or services from the provider or facility preparing it. Current CMS guidance notes that estimates presently may list only one provider or facility even when more than one will be involved, so a patient may need to request estimates from each.

Keep the written estimate and compare it with the bill. Care that could not reasonably be anticipated may not appear on the estimate.

If your bill is higher than the estimate

A federal patient–provider dispute process may be available if a provider or facility bills you at least $400 more than the Good Faith Estimate from that provider or facility. CMS says you must start the dispute within 120 days of receiving the initial bill.

Eligibility and process details can change. Check the current CMS dispute information and keep the estimate, initial bill, and related documents.

Questions and limits

Good Faith Estimates are for expected, scheduled care and are not provided during emergency care. For questions about an Ocean Chiropractic Center estimate or bill, call (415) 841-0115. For current federal guidance, see CMS information for people who are not using health insurance.