Your Right to Receive a Good Faith Estimate of Expected Charges
Under the No Surprises Act, you have the right to receive a Good Faith Estimate explaining the expected cost of healthcare services if you are uninsured or choose not to use insurance for your care.
A Good Faith Estimate will include the reasonably expected costs of items and services that may be provided in connection with your care.

Who Can Receive a Good Faith Estimate?
You may request a Good Faith Estimate if you:
Do not have health insurance;
Are not submitting a claim to your health insurance plan; or
Are choosing to pay for services without using insurance.

When Will You Receive a Good Faith Estimate?
If you schedule healthcare services at least three business days in advance, you have the right to receive a Good Faith Estimate in writing at least one business day before your scheduled service.
If you schedule services at least 10 business days in advance, you have the right to receive a Good Faith Estimate in writing at least three business days before your scheduled service.
You may also ask Dawning Resilience PLLC for a Good Faith Estimate before scheduling services.

Understanding Your Estimate
A Good Faith Estimate is an estimate of the costs reasonably expected for your care based on the information available at the time it is provided. Actual services and costs may vary based on your individual treatment needs, changes in your care, and other factors. Your Good Faith Estimate is not a contract and does not require you to receive services from Dawning Resilience PLLC.

What If Your Bill Is Higher Than Your Estimate?
If you receive a bill that is substantially higher than the amount listed in your Good Faith Estimate, you may have the right to dispute the bill through the federal patient-provider dispute resolution process. Keep a copy or photograph of your Good Faith Estimate for your records.

For questions about your Good Faith Estimate, payment options, or your rights, please contact:
Dawning Resilience PLLC
1100 31st Ave SW, Suite 2
Minot, ND 58701
Phone: 701.707.1383

For more information about your rights under the No Surprises Act and the Good Faith Estimate requirements, please visit the appropriate federal resources.