Good Faith Estimate

‍Under the No Surprises Act, if you are a self-pay or uninsured patient, you have the right to request and receive a “Good Faith Estimate” explaining how much your health care will cost.  This includes related costs like medical tests, prescription drugs and equipment.

If you schedule a health care item or service at least three (3) business days in advance, you are entitled to receive a Good Faith Estimate in writing within one (1) business day after scheduling. If you schedule a health care item or service at least ten (10) business days in advance, you are entitled to receive a Good Faith Estimate in writing within three (3) business days after scheduling. You can request this Good Faith Estimate by calling your Salma Health clinic. 

If you receive a bill that is greater than your Good Faith Estimate from that provider or facility, you may be entitled to dispute the bill. 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.