Protect Against Penalties for Non-Compliant Good Faith Estimates

Date: Tuesday, December 13, 2022 1:00PM ET Length: 60 Minutes Expert: Jonathan G. Wiik, MSHA, MBA, CHFP

Federal laws that require you to provide uninsured (self-pay) patients with compliant Good Faith Estimates are no longer considered interim. Unfortunately, this change opens the door for investigators to dig around in your practice looking for violations.

The problem is that there are thousands of variables that you must consider when trying to comply with Good Faith Estimate rules. For example: If Federal and State laws differ, which one should you use? How do balanced billing rules apply? What if you miss the 3-day deadline when providing a Good Faith Estimate?

Good Faith Estimate federal regulations are vague and confusing, and if not done right, they leave you exposed to significant government financial penalties. Penalties range from the complete waiver of a patient’s bill to a fine of up to $10,000 per offense.

So, if Good Faith Estimate rules are confusing and unclear, how can the government expect you to comply? The bottom line is that they just do. Fortunately, there is help available.

During an upcoming online training session on Tuesday, December 13th at 1 pm ET, healthcare compliance expert Jonathan G Wiik, MHA, MBA, will walk you through the specifics of preparing a correct, compliant Good Faith Estimate. During this training, he’ll boil down confusing Good Faith Estimate regulations into clear, understandable actions that help you avoid errors that lead to lost revenue, audits, and sky-high monetary penalties.

Here are just a few of the questions you’ll get answered during this upcoming 60-minute online training that will help you comply with the complexities of providing an accurate Good Faith Estimate to your uninsured (self-pay) patients:

  • How can you give an accurate Good Faith Estimate without a diagnosis?
  • Are your estimates required to include possible financial assistance options?
  • What should you include when calculating a QPA (Qualifying Payment Amount)?
  • What charges should you include or exclude on an estimate?
  • What disclaimers must you include on Good Faith Estimates to comply with the law?
  • Does the type of service you provide dictate the format of your estimate?
  • Do all patients have to receive the exact same rates regardless of situation?
  • If a patient has insurance but chooses to self-pay, is a Good Faith Estimate required?
  • What format must your Good Faith Estimate be in – hard copy or electronic?
  • If your practice posts its prices, are you still required to provide a Good Faith Estimate?
  • What if you need to change your initial Good Faith Estimate?
  • How detailed must your Good Faith Estimate be (i.e., supplies, etc.)?
  • Does providing your estimate over your patient portal comply with requirements?
  • And so much more!

Providing your uninsured (self-pay) patients with a compliant Good Faith Estimate is a massive administrative burden on your practice. But you really have no choice. The compliance of your practice’s billing and collection processes are dependent on your ability to master the nuances of this complex regulation. It’s the only way your practice can avoid the civil violation penalties of up to $10,000 for each occurrence.

Don’t risk making a mistake when providing an accurate Good Faith Estimate for your self-pay patients. You are required to adhere to the new No Surprises Act regulations. Don’t risk running afoul of the law and getting your practice slapped with a fine or losing revenue when a patient disputes a bill. Register for this online training today!

Meet Your Expert

Jonathan G. Wiik
MSHA, MBA, CHFPVice President, Health Insights

Jonathan Wiik has 25 years of healthcare experience in acute care, health IT and insurance settings. He started his career as a hospital transporter and held various roles (clinical operations, patient access, billing, case management and more) at a large, not-for-profit, acute care hospital, before serving as the hospital’s chief revenue officer.

He also served in various roles at a prominent commercial payer. His cumulative expertise gives him vast knowledge of — and keen insight into — the inner workings of the revenue cycle across the continuum of care. He currently serves as a Principal of Healthcare Strategy at TransUnion Healthcare.

Wiik is an active advocate of legislative changes that evolve the healthcare industry. He’s the author of Healthcare Revolution: The Patient Is the New Payer and his latest book, Healthcare Evolution: Helping Providers Get Paid in an Era of Uncertainty, and frequently speaks as a thought leader at state and national events and conferences.