No Surprises Act

You have the right to a Good Faith Estimate explaining the cost of your health care. 

Patients who do not have insurance, or who are not using insurance, must be provided with an estimate of the bill for medical care by the healthcare organization. 

  • You have the right to a good faith estimate for the total cost of non-emergency care or services. This includes tests, procedures, and hospital fees. 
  • You will be provided with a good faith estimate when your test or procedure is scheduled at least 3 days in advance and the estimate will be provided within 24hrs of scheduling. 
  • If you receive a bill after the procedure or test that is greater than $400 than your estimate, you have the right to appeal. 
  • The Good Faith Estimate must be provided to you in a way that you can save it for reference (email, mail, patient portal, etc). 

For questions or more information about your right to a good faith estimate, visit www.cms.gov/nosurprises or call PVH to speak with an expert at 207-794-7174 to request an estimate. 

To create a Good Faith Estimate, visit our Price Transparency page and find the Patient Estimator Tool.

PVH Balance Billing Rights