Good Faith Estimates (GFE's)
Question: What is a Good Faith Estimate? Answer: You have the right to receive a good faith estimate of the amount you will be billed for scheduled or non-emergency items or services. The estimate should include costs for items and services anticipated to be provided with the visit, such as medical tests and hospital fees. You are entitled to receive the estimate in writing at least 1 business day before your scheduled medical service or item. You can also ask your health care provider, and any other provider you choose, for a good faith estimate before you schedule an item or service. If you are insured, you also may request a good faith estimate of the amount you will be billed for non-emergency items and services that you might like to schedule. Whether or not you have insurance, if the estimate you receive for the anticipated items and services substantially exceeds the amount billed to you as your responsibility, you can dispute the bill. Please save a copy or picture of your good faith estimate. Noninsured Patients: All health care providers are required to give uninsured patients, those who don’t have insurance or who are not using insurance, an estimate of the amount they will be billed for scheduled items or services or upon request for other non-emergency items or services. All Patients: Anyone with or without insurance may also request a good faith estimate. This information is included in your intake paperwork that you will complete in our online portal. However, if you prefer, you can reach out to our billing staff by calling 617-244-2700 and request a phone discussion or email that will contain a good faith estimate of what you might be billed. Insurance Company Clarification: It is also important to reach out to your insurance company to clarify your typical copayments, and yearly deductible for in-network and out-of-network services, as well as any yearly individual/family limits that you might have on out-of-pocket expenses. Self-Insured Companies: Please be aware that if you work for a company that is self-insured, your company is not compelled to pay for typical services that are mandated by state and federal guidelines. You will need to contact your human resources department to clarify details around how your benefits will be managed by your company in the state of Massachusetts in order to clarified if you will be covered and how your deductibles will be addressed. You must clarify with our intake staff that you have a self-insured plan. Additional Federal Resources: For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the No Surprises Helpdesk at 1-800-985-3059. |