How do I dispute a bill that's $400 or more over my Good Faith Estimate?

This dispute process is only for patients who are uninsured or self-pay (you chose not to use insurance). If you used insurance, see "If you have insurance" below.Source: No Surprises Act, CMS, via hospitalbillchecker.com/your-rights, section 3

What the rules say

• If you schedule care at least 3 business days ahead, or ask for an estimate, providers and facilities must give you a Good Faith Estimate of expected charges.
• If your final bill from any one provider or facility is at least $400 more than its Good Faith Estimate, you can start a patient-provider dispute through the federal government.
• You must start the dispute within 120 calendar days of the date on the original bill. There's a small administrative fee.

Source: No Surprises Act, CMS (cms.gov/nosurprises), via hospitalbillchecker.com/your-rights, section 3

Steps

1. Find your Good Faith Estimate and the bill from the same provider or facility.
2. Compare the totals for that one provider or facility. Check whether the bill is at least $400 more.
3. Check the date on the original bill. You have 120 calendar days from that date to start.
4. Start the dispute through cms.gov/nosurprises, or call the No Surprises Help Desk at 1-800-985-3059.
5. Keep copies of the estimate and the bill.

If you have insurance

The No Surprises Act also protects insured patients from most surprise out-of-network bills. That covers emergency care, and certain care from out-of-network providers at in-network hospitals. In those cases you generally owe only your in-network cost-sharing. Your insurer, using the number on your card, is a place to start.Source: No Surprises Act, CMS, via hospitalbillchecker.com/your-rights, section 3

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