
Ever since the No Surprises Act went into effect in 2022, your medical practice has been required to provide good faith estimates to patients. This allows them to avoid receiving surprise medical bills by giving them the opportunity to understand how much they’ll be responsible for.
Read on to discover three good faith estimate (GFE) myths, along with the truths you must follow to stay in line with the law.
Myth 1: The GFE Only Applies to Uninsured Patients
Many practices know that they must offer a good faith estimate to uninsured patients so the patients can get a feel for what the service will cost them. The problem arises when practices think those are the only patients that require a GFE.
While uninsured patients comprise one group requiring a good faith estimate, you must also provide a GFE to patients who are insured but don’t want the item or service submitted to their insurer. These are considered self-pay patients, and all self-pay patients must be given a GFE.
In fact, any time a patient asks about the potential costs of items or services, your best bet is to offer them a good faith estimate. The caveat is that you aren’t required to provide a GFE if the item or service isn’t scheduled at least three days in advance. This means that if the patient is getting a particular service on the same date that they request the GFE, the law doesn’t require that you give it to them. However, many practices still provide it upon request in these circumstances as a matter of positive patient relations.
Myth 2: All Good Faith Estimates Must Be on Paper
You’re within your rights to provide patients with good faith estimates in paper form, but they’re also legal if you provide them electronically. Essentially, the GFE tells the patient how much they should be expected to pay for a requested item or service that they’ve scheduled with your practice.
Whether it’s digital or paper is not at issue. What’s at issue is that you include all information from co-providers and other facilities that will be billing the patient for this service so they only have to review a single GFE for that date of service.
Myth 3: The Good Faith Estimate Is a Binding Contract
Providing patients with a GFE does not mean the patient is then legally bound to go through with the procedure. In reality, your good faith estimate must include a disclaimer reminding them that the GFE is not a contract and they’re under no obligation to actually follow through with the item or service discussed in the estimate. Instead, the GFE is a notification of how much they’ll owe if they choose to get the item or service.
There’s a lot more to know about staying compliant with the good faith estimate regulations. Let attorney Amanda Waesch, Esq., walk you through the details during her latest online training, Comply with Good Faith Estimate Complexities and Get Paid More. Register today! |
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