Good Faith Estimate
A No Surprises Act-required written estimate of expected charges for uninsured or self-pay patients.
Updated
A Good Faith Estimate (GFE) is a written estimate of the expected charges for scheduled health care items or services, required by the No Surprises Act for patients who are uninsured or who choose to self-pay rather than use their insurance.
Providers and facilities must furnish the estimate within specified timeframes based on when the service is scheduled, and patients may dispute bills that exceed the estimate by a defined threshold.
In practice
Billing operations must capture self-pay status, generate GFEs on request or automatically for scheduled services, retain documentation, and operate the patient-provider dispute resolution workflow when actual charges exceed the estimate beyond the allowed margin.
Commonly confused with
- Out-of-pocket estimate: An out-of-pocket estimate is produced for insured patients based on plan coverage; a Good Faith Estimate is specifically for uninsured or self-pay patients under the No Surprises Act.