The Good Faith Estimate is a major component of the No Surprises Act. The document is a listing of all charges that a patient could expect if they move forward with a medical procedure/service.
Currently, a Good Faith Estimate (GFE) is required to be given to all patients who have no insurance, choose not to use their insurance for a particular procedure/service, or ask for one. The main provider is referred to as the convening provider under the No Surprises Act. This means that this main provider is responsible to gather and list all of the charges that a patient could expect for a particular service.
For example, let's say a patient needs an operation on their knee at the local ambulatory surgery center. The convening provider in this example would be the surgeon. The surgeon's office would be responsible for collecting fees from the ambulatory surgery center, anesthesiologist, surgical assistant, pathologist, laboratory, durable medical equipment (DME) supplier, and physical or occupational therapy needed or others involved in this particular procedure and displaying them on a single Good Faith Estimate for the patient.
If after the surgery is over and the final invoice is sent to the patient, the amount of their invoice is $400 or higher than their original Good Faith Estimate states, the patient could contest the amount and if decided in their favor, they would not have to pay the additional charges. If there is a good reason why the invoice is more than $400 over the original Good Faith Estimate (maybe the patient coded on the table, the surgeon found additional damage that needed to be addressed while the patient was on the OR table, etc), and it's documented in the patient's chart, the patient would be liable for those charges.
As you can imagine, this is a LARGE and potentially expensive responsibility for the convening provider's office. Failure to comply with the No Surprises Act/Good Faith Estimate could result in a civil penalty of up to $10,000 per occurrence.
DrChrono has built a tool for practices to utilize to assist in providing Good Faith Estimates to their patients. Here is a link to the section in our knowledge base that contains additional, client-facing articles regarding the Good Faith Estimate - https://support.drchrono.com/hc/en-us/sections/15527007442075-Good-Faith-Estimate
