What a Good Faith Estimate is and how to ask for one

The estimate, defined

A Good Faith Estimate is a written estimate, from a provider or facility, of what they expect to charge you for a service. It is meant for people who are uninsured or who are choosing to pay for the service themselves.

It is different from a posted price. A posted price is what a provider lists publicly for a service. A Good Faith Estimate is written for you, for the service you are scheduling. When you later compare a bill against an estimate, the Good Faith Estimate is the number to use, not the posted price.

Who can ask, and when it is required

If you are uninsured, or you are paying for yourself, you can ask a provider for a written Good Faith Estimate. When you schedule a service at least three business days ahead, the provider must give you one. The federal rule is 45 CFR 149.610.

You do not need a reason to ask, and asking does not commit you to booking. You can ask two or three providers for estimates on the same service and then decide.

How to ask

Ask plainly and ask for it in writing. On the phone or in a message, something like this works:

“I am paying for this myself. Before I schedule, I would like a written Good Faith Estimate for a knee MRI without contrast. Please send it to me by email or mail.”

Use the exact name of the service your doctor ordered. If there is a procedure code on the order, include it. Then write down the date you asked, who you spoke with by role (for example, the scheduling desk), and how they said they would send it.

What to check when it arrives

Read it the day it arrives, so any questions get answered before your appointment. Check that it matches what you are actually having done.

• The service named is the one on your order.
• The date of service or scheduling date is right.
• It lists the items and services the provider expects to charge for.
• It says whether other providers or facilities may bill you separately.
• Your name and contact details are correct.

Why it is worth the trouble

An estimate in writing turns a phone conversation into something you can point to. It helps you plan, and it helps you compare. If the final bill from any one provider or facility comes in at least $400 more than its Good Faith Estimate, you may be able to start the federal patient-provider dispute process, within 120 calendar days of the date on the bill (45 CFR 149.620). That option depends on having the estimate, so keep it.

Store the estimate with the date you received it, and later with the bill. If you had estimates from more than one provider for the same visit, keep each one separately. The $400 is counted per provider or facility, not across the whole visit.

If a provider does not send one

Ask again in writing, and keep a copy of your request. Note the date and how you asked. If you still have not received an estimate, you can decide whether to book there or with a provider who sent one. Either way, your written requests are part of your record.