No Surprises Act

You have the right for 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 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 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 or call PVH Patient Financial Services at 207-794-7194 to request an estimate. 

To create a Good Faith Estimate, click here for the Patient Liability Estimator or call 207-794-7194 for a member of our team to create an estimate for you. 

PVH Balance Billing Rights