No Surprises Act Requirements: Good Faith Estimates for Uninsured and Self-Pay Patients (enduring)-No Surprises Act Requirements: Good Faith Estimates for Uninsured and Self-Pay Patients

Video Transcription

Video Summary

In tonight's webinar on the No Surprises Act Requirements, Bob Jasek and Cindy Moon discussed the Good Faith Estimates (GFEs) for uninsured and self-pay patients. GFEs are written documents that outline a patient's expected charges for a scheduled or requested item or service. They must include all items or services that would be reasonably expected to be furnished in conjunction with the scheduled or requested item or service. The GFEs should reflect the cash pay rate, including any anticipated discounts or adjustments. Providers are responsible for determining if a patient is uninsured or self-pay and for contacting co-providers to obtain their expected charges within one business day of receiving a GFE request. GFEs must be provided to patients at least three business days after scheduling or after a request is made. Providers must also provide a notice to patients that GFEs are available and display this notice prominently on their website and in their office. The webinar also covered the patient-provider dispute resolution process, which allows uninsured or self-pay patients to dispute charges that are substantially in excess of the GFE. Disputes must be submitted within 120 calendar days of receiving the initial bill, and providers are encouraged to submit disputes through the federal independent dispute resolution portal. The GFE requirements do not apply to patients insured under federal healthcare programs. The enforcement of these requirements varies by state, with some states acting as primary enforcers. The webinar provided a valuable overview of the No Surprises Act requirements for GFEs and the patient-provider dispute resolution process.

Keywords

No Surprises Act Requirements

Good Faith Estimates

GFEs

uninsured patients

self-pay patients

expected charges

cash pay rate

anticipated discounts

patient-provider dispute resolution process