What Is a Good Faith Estimate (GFE) and What Does It Contain?

Healthcare costs are often difficult for patients to understand in advance. The Good Faith Estimate (GFE), introduced as part of the No Surprises Act, was created to provide clarity. A GFE outlines the expected charges for medical services before care is delivered, helping patients make informed decisions and prepare for potential expenses.
What Is a Good Faith Estimate?
A Good Faith Estimate is a written explanation of anticipated costs for a scheduled service or procedure. Providers, co-providers, and facilities are required to supply this information within one to three business days of scheduling. Depending on the situation, the estimate may be sent directly to the patient or to the patient’s health plan.
The purpose of a GFE is to improve transparency, reduce unexpected costs, and establish clear communication between patients and providers.
What Does a GFE Include?
A Good Faith Estimate (GFE) goes beyond presenting a single price; it offers a comprehensive breakdown of the potential costs associated with a patient’s care. This includes provider fees, such as charges for consultations or examinations, as well as facility fees, which cover the use of a hospital, clinic, or outpatient center. It also outlines costs for laboratory services, including blood tests, pathology, or other diagnostic work, along with imaging services such as X-rays, ultrasounds, MRIs, or genetic testing.
In addition, a GFE may detail procedural costs, like anesthesia, surgical supplies, or specialized equipment, and co-provider services, which represent charges from additional specialists such as radiologists, pathologists, or anesthesiologists. Together, these elements ensure that patients have a clearer picture of the financial aspects of their care before receiving services.
READ MORE: What Is Price Transparency in Healthcare?
How Estimates Differ by Specialty
The contents of a Good Faith Estimate (GFE) can differ significantly depending on the medical specialty and the type of care a patient receives. In primary care, for example, a routine physical may include charges for the office visit itself, standard laboratory work, and any recommended immunizations. In oncology, a biopsy could involve multiple layers of cost, such as anesthesia, pathology services, and facility fees, in addition to the oncologist’s professional services.
Similarly, in obstetrics and gynecology, prenatal care often requires a combination of examinations, ultrasounds, laboratory testing, and genetic screening. These variations highlight how a GFE adapts to the unique scope of each specialty, ensuring patients receive an estimate that reflects the full spectrum of potential services tied to their care.
Because multiple providers and facilities are often involved, assembling an accurate and comprehensive GFE requires coordination across care teams.
Streamlining GFEs with Technology
Creating accurate and timely GFEs can be challenging when information must be gathered from different systems and providers. Technology can simplify this process by automating estimates, coordinating data, and ensuring that patients receive complete and accurate information.
The seeQer platform by careviso is designed to support providers in generating Good Faith Estimates efficiently and in compliance with regulations. By streamlining the process, seeQer helps both patients and providers navigate the financial side of care with greater confidence and clarity.
READ MORE: AI in Prior Authorization: How Technology is Streamlining Access to Care
Why Good Faith Estimates Are Important
Good Faith Estimates benefit patients by clarifying costs before care is delivered, reducing confusion, and allowing for better financial planning. They also support providers by ensuring compliance with federal requirements, decreasing billing disputes, and strengthening trust in the patient/provider relationship.
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