Good Faith Estimate: Know Your Healthcare Costs Upfront
A Good Faith Estimate is your right to know healthcare costs before treatment. Learn how to request one, what it must include, and how to dispute bills that exceed it.
What Is a Good Faith Estimate?
A Good Faith Estimate (GFE) is a written estimate of expected charges for scheduled healthcare services. Under the No Surprises Act (effective January 2022), healthcare providers and facilities must give you a GFE if you're uninsured, self-pay, or request one. This lets you know costs upfront and compare prices before committing to treatment.
Who Can Get a Good Faith Estimate?
Good Faith Estimates are primarily designed for patients without insurance or those choosing to pay out-of-pocket (self-pay). However, anyone can request cost information. If you have insurance but want to understand the full cost picture, you can ask for a GFE and then work with your insurer on coverage separately.
- Uninsured patients: Entitled to a GFE for all scheduled services
- Self-pay patients: Choosing not to use insurance for a service
- Insured patients: Can request but formal GFE protections may not apply
- Applies to all healthcare providers and facilities
- Covers medical, mental health, dental, and other health services
What Must a Good Faith Estimate Include?
A proper Good Faith Estimate must contain specific information to help you understand and compare costs:
- Patient name and date of birth
- Description of each item or service
- Diagnosis codes and service codes (CPT/HCPCS)
- Expected charges from the primary provider
- Expected charges from any other providers or facilities involved
- List of all providers expected to furnish services
- Disclaimer explaining this is an estimate and actual charges may vary
- Notice about your right to dispute bills exceeding the estimate
When You Should Receive a Good Faith Estimate
Timing matters for Good Faith Estimates. Providers must give you a GFE within specific timeframes based on when your service is scheduled:
- If scheduled 3+ business days ahead: GFE within 1 business day of scheduling
- If scheduled 10+ business days ahead: GFE within 3 business days of scheduling
- You can also request a GFE before scheduling to compare providers
- Must receive at least 1 business day before the service
Your Right to Dispute Bills Exceeding the Estimate
If your final bill exceeds your Good Faith Estimate by $400 or more, you have the right to dispute it through the Patient-Provider Dispute Resolution (PPDR) process. You must initiate the dispute within 120 days of receiving the bill. An independent reviewer will determine if the charges are reasonable, and their decision is binding on the provider.
How to Use Good Faith Estimates Effectively
Good Faith Estimates are powerful tools for managing healthcare costs. Request estimates from multiple providers to compare prices—you may find significant differences for the same procedure. Use the estimate to plan financially. If the final bill exceeds the GFE, you have leverage to negotiate or dispute. Keep the estimate as documentation.
How to Get and Use a Good Faith Estimate
Request the estimate
When scheduling a procedure, ask for a Good Faith Estimate. You can also request one before scheduling to compare providers. Be specific about what services you need.
Review all components
Ensure the GFE includes all providers involved—surgeon, anesthesiologist, facility fees, labs, etc. If any are missing, ask for them to be added. Incomplete estimates leave you vulnerable to surprise charges.
Compare providers
Request GFEs from multiple providers for the same service. Prices can vary dramatically (sometimes by 500% or more) for the same procedure. Use this information to make informed decisions.
Save the estimate
Keep your Good Faith Estimate in a safe place. You'll need it to compare against your final bill and as documentation if you need to dispute charges.
Dispute if bill exceeds estimate by $400+
If your final bill is $400 or more above the GFE, initiate a dispute through the Patient-Provider Dispute Resolution process within 120 days. The provider cannot send you to collections during the dispute.
Frequently Asked Questions
What is a Good Faith Estimate?
A Good Faith Estimate (GFE) is a written estimate of expected charges for healthcare services that providers must give to uninsured or self-pay patients before treatment. It helps you understand costs upfront and compare prices.
Who is entitled to a Good Faith Estimate?
Under the No Surprises Act, uninsured patients and those choosing to self-pay are entitled to a GFE. Insured patients can also request cost information, though the formal GFE protections may not apply.
What if my bill is higher than the Good Faith Estimate?
If your final bill exceeds the GFE by $400 or more, you can dispute it through the Patient-Provider Dispute Resolution process. You have 120 days from receiving the bill to initiate a dispute.
How far in advance should I request a Good Faith Estimate?
Request it when scheduling your service. If scheduled 3+ days ahead, you should receive it within 1 business day. You can also request estimates before scheduling to compare multiple providers.
Does a Good Faith Estimate include all charges?
A complete GFE should include charges from the primary provider and all other providers/facilities involved. However, estimates can be incomplete—always ask if all anticipated providers are included.
Can I negotiate based on a Good Faith Estimate?
Yes. Use GFEs from multiple providers as leverage to negotiate better prices. If one provider is significantly cheaper, others may match or beat their price to earn your business.
Got a Good Faith Estimate?
Upload your estimate and we'll help you understand the charges, compare them to fair prices, and identify areas where you might negotiate.
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