Good Faith Estimate

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 patients who don't have insurance or who are not using insurance an estimate of the bill for medical items or services.

• You have the right to receive a Good Faith Estimate for the total of expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment and hospital fees.
• Make sure that your health care provider gives you a Good Faith Estimate in writing at least 1 business day before the medical service or item. You can also ask your health care provider, and another provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure you save a copy or picture of your Good Faith Estimate.
• If you have questions about your Good Faith Estimate please contact us at
  801-475-3500.

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