No Surprises Act and Good Faith Estimates
Getting cost estimates before you get care
If you are uninsured or don’t plan to submit your claim to your health plan, health care providers and facilities must provide you with a “good faith estimate” of expected charges before you get an item or service. The good faith estimate is not a bill.
Cook County Health must give you a good faith estimate if you ask for one, or when you schedule a service. It will include expected charges for the primary service you are getting, and any other items or services provided as part of the same scheduled experience.
Estimates will be provided within 1 to 3 business days of an appointment being scheduled or from when a request for an estimate is submitted.
The estimate will include an itemized list with specific details and expected charges for items and services related to your care. The estimate will be provided in writing, either on paper or electronically, in a way that is accessible to you. You can request us to discuss the information in the estimate with you over the phone or in person.
Self-pay patients receive a 30% discount. If you are uninsured, you may qualify for Cook County Health’s financial assistance program, CareLink. Click here to read more.
To request a Good Faith Estimate, please click here to access Cook County Health’s Good Faith Estimate form.Note: You could be charged more than the estimate if you get additional items or services during your visit or procedure that your doctor did not anticipate.
Disputing charges higher than the estimate
Once you get your good faith estimate from Cook County Health, keep it in a safe place so you can compare it to bills you get later.
If you get the bill and the charges are at least $400 above the good faith estimate, please contact CCH at 866. 223.2817.
If you are not satisfied with the outcome, you may be eligible to start a patient-provider dispute with the U.S. Centers for Medicare & Medicaid Services. Please visit https://www.cms.gov/nosurprises/consumers/medical-bill-disagreements-if-you-are-uninsured o llamar 1.800.985.3059.
There is a $25 fee to use the CMS process to dispute a medical bill that is higher than the provided good faith estimate. If the agency reviewing your dispute agrees with you, you will have to pay the amount provided on the good faith estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the charges as billed.
For more information about good faith estimates, go to www.cms.gov/nosurprises o llamar 1.800.985.3059.