Billing & coverage
No Surprises Act and Good Faith Estimates
Federal protections against many surprise out-of-network bills, and price estimates for people who are uninsured or self-paying.
Key points
- Covers most emergency services, certain non-emergency care by out-of-network clinicians at in-network facilities, and air ambulance services.
- In protected situations, cost sharing is limited to in-network amounts and balance billing is generally prohibited.
- Uninsured or self-pay patients can request a Good Faith Estimate before scheduled care.
- If a bill is at least $400 more than the Good Faith Estimate from a provider, the patient may be able to start the patient-provider dispute process — generally within 120 days of the bill.
- Ground ambulance is not covered by the federal surprise-billing protections; some states have their own laws.
In practice
- Ask whether the client signed a notice-and-consent form waiving protections, and whether that waiver was allowed for the service.
- Keep the estimate, the bill and dates together — the dispute window is time-limited.
- Check the state's own surprise-billing law, which may add protections.
Official sources
Educational summary, not legal advice. Deadlines depend on the notice, plan type and state.
Sources checked November 7, 2026. Rules change — confirm with the official source before acting.