Employees Who Create Patient Estimates No Surprises Act Requires Good Faith Estimates for Self-Paying/Uninsured Patients
Employees Who Create Patient Estimates No Surprises Act Requires Good Faith Estimates for Self-Paying/Uninsured Patients
HM will now provide a good faith estimate (GFE) for self-pay or uninsured patients that combines both HM hospital billing (HB) and HM professional billing (PB) charges into a single estimate. This combined estimate will be provided for scheduled hospital services or upon patient request. This change supports our effort to be in compliance with the No Surprises Act. When fully operationalized, the GFE will also include expected charges for all items or services reasonably expected to be delivered, including external provider charges. The facility responsible for scheduling the primary service must coordinate all estimates and deliver a single, comprehensive GFE to the patient.
Although the No Surprises Act became law on Jan. 1, 2022, CMS has delayed their initial plan to penalize providers who don’t include GFEs for co-providers or co-facilities on Jan. 1, 2023. The new deadline hasn’t been set.
