Patient Estimates
Disclaimer
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. This Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment and therefore, you could be charged more than what is listed in the Good Faith Estimate, if complications or special circumstances occur. Should your bill be more than the charges listed on the Good Faith Estimate, you may contact UMMC to let us know the billed charges are higher. You can ask us to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. Please call us at 601-984-6650 to discuss any concerns you have about this Good Faith Estimate. If your bill is substantially more than the charges listed on the Good Faith Estimate provided to you, federal law allows you to dispute the bill utilizing the U.S. Health and Human Services' Patient-Provider Dispute Resolution (PPDR) Process. Additionally, if your bill is $400 or more than your Good Faith Estimate, the item or service may be eligible for payment determination by a Selected Dispute Resolution (SDR) entity through PPDR process. Please note that HHS charges a $25 fee to use the dispute process. If the Selected Dispute Resolution (SDR) entity reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate, reduced by the $25 fee. If the SDR disagrees with you and agrees with UMMC, you will have to pay the higher amount. To initiate the PPDR process, including requesting a SDR determination, or if you have questions about your right to a Good Faith Estimate, you may visit www.cms.gov/nosurprises/consumers, send an email to FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059. If you dispute your bill, UMMC cannot move the bill for the disputed item or service into collection or threaten to do so, or if the bill has already moved into collection, UMMC has to cease collection efforts. UMMC must also suspend the accrual of any late fees on unpaid bill amounts until after the dispute resolution process has concluded. UMMC cannot take or threaten to take any retributive action against you for disputing your bill. The Good Faith Estimate is not a contract and does not require you to obtain the items or services from any of the providers or facilities identified in the Good Faith Estimate Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.