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If you don't have health insurance or you plan to pay for health care bills yourself, generally, health care providers and facilities must give you an estimate of expected charges when you schedule an appointment for a health care item or service, or if you ask for an estimate. This is called a “good faith estimate.”

denial for authorization If your DR did not get authorization for the services then the doctor will not get paid and you can not bill the patient because it is the DR responsibility to obtain precert/authorizations.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

The No Surprises Act protects consumers who get coverage through their employer (including a federal, state, or local government), through the Health Insurance Marketplace® or directly through an individual health plan, beginning January 2022, these rules will: Ban surprise billing for emergency services.

Disclaimer (example) The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

Penalties. The primary consequence for failing to provide a sufficient good faith estimate if required is that a patient may force the Selected Dispute Resolution ("SDR") process and likely avoid paying his or her full bill if the actual charges are more than $400 over the expected charges. (45 CFR § 149.620).