Know the Methods for Providing Good Faith Estimates

Know the methods for providing Good Faith Estimates - A good faith estimate must be provided and written using clear and understandable language.
Know the methods for providing Good Faith Estimates

Providers or facilities should provide a good faith estimate in written form either on paper or electronically, pursuant to the uninsured (or self-pay) individual’s requested method of delivery, and within the specified timeframes . Methods for providing good faith estimates provided electronically must be provided in a manner that the uninsured (or self-pay) individual can both save and print.

For uninsured (or self-pay) individuals without internet access, a paper copy of the GFE can be provided in person or mailed to an address specified by the uninsured (or self-pay) individual. For uninsured (or self-pay) individuals without a permanent address, the GFE can be provided electronically or in person. For uninsured (or self-pay) individuals who may be housing insecure and have limited or no internet access, a paper GFE can be provided in person. (Source: Good Faith Estimates FAQ 12.21.2021 FINAL (cms.gov))

Methods for Providing Good Faith Estimates

A good faith estimate must be provided and written using clear and understandable language. To the extent that an uninsured (or self-pay) individual requests a good faith estimate in a method other than paper or electronically (for example, by phone or orally in person), the convening provider may orally inform the individual of information contained in the good faith estimate using the method requested.

However, for a convening provider or convening facility to meet the requirements of this section, the convening provider or convening facility must also issue the methods for providing good faith estimate to the uninsured (or self-pay) individual in written form. Know all details about methods for providing good faith estimates from us.

Additional Requirements of Methods For Providing GFE

A good faith estimate issued to an uninsured (or self-pay) individual under this section is considered part of the patient’s medical record and must be maintained in the same manner as a patient’s medical record. Convening providers and convening facilities must provide a copy of any previously issued methods for providing good faith estimate furnished within the last 6 years to an uninsured (or self-pay) individual upon the request of the individual.

For all providers or facilities that issue methods for providing good faith estimates following their state’s processes and rules, if those state processes and rules do not meet federal good faith estimate requirements, those providers and facilities have failed to comply with federal good faith estimate requirements. A provider or facility will not fail to comply with federal methods for providing good faith estimate requirements solely because, despite acting in good faith and with reasonable due diligence, the provider or facility makes an error or omission in a required methods for providing good faith estimates, provided that the provider or facility corrects the information as soon as practicable.

If items or services are furnished before an error in methods for providing good faith estimates is addressed, the provider or facility may be subject to PPDR if the actual billed charges are substantially in excess of the methods for providing good faith estimates (as described later in this guidance).

To the extent compliance with federal good faith estimate requirements requires a provider or facility to obtain information from any other entity or individual, the provider or facility will not fail to comply with this section if it relied in good faith on the information from the other entity, unless the provider or facility knows, or reasonably should have known, that the information is incomplete or inaccurate. Find here all various details about methods for providing good faith estimates.

If the provider or facility learns that the information is incomplete or inaccurate, the provider or facility must provide corrected information to the uninsured (or self-pay) individual as soon as practicable. If items or services are furnished before an error in methods providing for good faith estimate is addressed, the provider or facility may be subject to PPDR if the actual billed charges are substantially in excess of the methods for providing good faith estimate.

Source: HHS PPDR Providers Guidance (cms.gov)

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