Send Email for Good Faith Estimate
For Self-Pay Patients:
If you would like a formal Good Faith Estimate regarding your upcoming scheduled services at UTMB Health, please Email the Patient Estimates team: patientestimates@utmb.edu and provide the following:
- Patient Name
- Date of Birth
- Date of Scheduled Procedure or CPT Codes, if not yet scheduled
You have the right to receive a Good Faith Estimate for the total expected self-pay cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For questions or more information about your right to a Good Faith Estimate, visit CMS: Ending Surprise Medical Bills webpage.
For Insured Patients:
UTMB can provide an estimate for health care services using your insurance benefits and the out-of-pocket requirements of your plan. To request an out-of-pocket estimate, please Email the Patient Estimates team: patientestimates@utmb.edu and provide the following:
- Patient Name
- Date of Birth
- Date of Scheduled Procedure or CPT Codes, if not yet scheduled