Good Faith Estimate for Health Care Items and Services

Under Section 2799B-6 of the Public Health Service Act, as of January 1, 2022, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care items and services.  

Good Faith Estimate form