Good Faith Estimate

How It Works

Since January 2022, the No Surprises Act requires healthcare providers and facilities to give uninsured or self-pay patients a Good Faith Estimate (GFE) of expected charges before providing scheduled services. The GFE must include expected charges for the primary service and any related services (anesthesia, lab work, imaging, etc.). If the final bill exceeds the GFE by $400 or more, the patient can dispute the bill through a patient-provider dispute resolution process. This provision gives uninsured patients more price information and legal protection than they've ever had before.

Related Terms

• Hospital Price Transparency — A federal rule (effective January 2021) requiring all U.S. hospitals to publicly display their prices — including chargemaster rates, negotiated rates with each insurer, and cash-pay discounts.
• Surprise Medical Bill (Balance Billing) — An unexpected bill from an out-of-network provider — often occurring during emergencies or when an in-network hospital uses out-of-network specialists without the patient's knowledge.
• Chargemaster (Charge Description Master) — A hospital's master list of prices for every item and service — from aspirin to surgery — typically containing tens of thousands of line items with prices that bear little relation to actual costs.