What Is a Good Faith Estimate? Everything You Need to Know
A good faith estimate (GFE) is a written estimate detailing the cost of medical services that will be provided to a patient. This is a legal requirement for non-emergent care and should be given to any self-paying patients, regardless of whether or not they have insurance.
In the complex landscape of healthcare, patients often find themselves facing unexpected medical bills, leading to financial strain and confusion. GFEs are a product of the No Surprises Act, which went into effect in 2022. They aim to provide patients with greater financial transparency and empower them to make informed decisions about their healthcare.
With transparency undoubtedly becoming a prominent component of the healthcare industry, good faith estimates are already becoming a vital part of any practice or lab involved with diagnostic testing and medical costs.
Frequently asked questions about good faith estimates include:
Is a good faith estimate required by law?
A good faith estimate is required for any non-emergency medical care. This could include medical testing, prescription drugs, hospital fees, or other expenses where the cost is known and finalized before treatment is provided.
Is a good faith estimate required for insured patients?
A GFE is required for any non-emergent care, whether the patient has insurance or not. Self-paying patients are also entitled to a GSE, even if they have insurance.
Can a good faith estimate be disputed?
While a patient cannot dispute the cost of a good faith estimate, they can decide whether or not to proceed with treatment based on the cost provided. However, if the final bill for medical services is more than $400 higher than the GFE provided, the patient can dispute the bill. The GFE is intended to avoid this type of cost discrepancy.
READ MORE: How good faith estimates vary by specialty
When should a GFE be provided to the patient?
The GFE needs to be given to the patient before the service is provided, with at least one business day’s advance notice.
In what forms must the GFE be provided?
The GFE must be provided in written form, either on paper or electronically.
Which providers and facilities are required to provide GFEs?
All providers and facilities that schedule items or services for an uninsured (or self-pay) individual or receive a request for a GFE from an uninsured (or self-pay) individual must provide such individuals with a GFE. No specific specialties, facility types, or sites of service are exempt from this requirement.
Do providers or facilities need to provide GFEs to all individuals?
Providers and facilities are required to provide GFEs to uninsured (or self-pay) individuals. This doesn’t include patients with Medicare or Medicaid, as these patients have insurance coverage.
Are you prepared to offer good faith estimates?
Adjusting to this new standard of healthcare can be daunting. If GFEs are creating a burden, we can help. careviso’s product seeQer, specializes in answering the cost and coverage questions plaguing patients, providers, and payors. Furthermore, by identifying out-of-pocket costs in advance, seeQer alleviates the burden associated with GFEs and empowers individuals to make informed decisions about their healthcare.
Discover how seeQer informs patients and transforms practice.
Schedule a seeQer demonstration of benefits verifications, cost assessments, and other essential tasks in the platform. Learn how seeQer can help your organization reduce administrative burden, transform cumbersome processes, and provide transparency that empowers patients in a complex and ever-changing industry.