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Good Faith Estimate

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 and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other 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 to save a copy or picture of your Good Faith Estimate.

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

To get an estimate, complete the following steps:

  • Request CPT code from your doctor’s office.
  • Call us at 802-542-3778. Confirm patient name, birthday, insurance and provide CPT code. We’ll get back to you within five business days.
  • Call your insurance company to find out the portion you will need to pay based on your individual plan’s coinsurance and deductible amounts.
844-UVM-HEALTH

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111 Colchester Ave
Burlington, VT 05401

802-847-0000

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111 Colchester Ave
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Berlin, VT 05602

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Plattsburgh, NY 12901

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Elizabethtown, NY 12932

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Malone, NY 12953

518-483-3000

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115 Porter Drive
Middlebury, VT 05753

802-388-4701

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Colchester, VT 05446

802-658-1900

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