FOR INSURANCE AND BILLING ISSUES

Please contact Privia Support at (888) 774-8428

Navigating the world of healthcare expenses can be a daunting task, for both insureds and self-pay patients. The good news is that the introduction of the Good Faith Estimate (GFE) by healthcare providers is here to make your journey towards understanding medical costs much friendlier. Today, we’ll break down what a Good Faith Estimate is, why it’s essential, and how it can help you plan ahead for your healthcare expenses with confidence.

Demystifying the Good Faith Estimate (GFE)

Have you ever received a medical bill that felt like a surprise package you never wanted to open? You’re not alone! Medical billing can often be complex and confusing, leaving patients in the dark about the true cost of their care. However, the Good Faith Estimate is a welcome beacon of transparency in this sea of uncertainty.

A Good Faith Estimate is a document provided by your healthcare provider that outlines the estimated costs of your medical services BEFORE you receive them. It’s like having a clear roadmap of your medical expenses, allowing you to plan your budget and make informed decisions about your healthcare.

Why Is It Essential?

Transparency: The GFE aims to make healthcare pricing more transparent. It helps you understand the costs associated with your treatment, so you’re not left in the dark.

Financial Planning: With a GFE in hand, you can budget for your medical expenses, which is especially valuable for self-pay patients who don’t have insurance coverage.

Empowerment: It empowers you to make informed choices about your care. You can explore cost-effective options and understand what you’re paying for.

How to Get Your Good Faith Estimate

Getting a GFE is easy and should be a standard practice for healthcare providers. When scheduling a medical procedure or appointment, simply ask for a Good Faith Estimate. You have the right to this information, and it’s in the provider’s best interest to give it to you.

For patients of our office, once you make an appointment via the patient portal, please include the request for GFE.  Once we have your appointment and paperwork confirmed, we can proceed.  For insurance patients, there may be a slight delay as we will need to forward the request to your insurance provider.

What Information Does It Include?

A Good Faith Estimate typically includes the following:

• The estimated cost of the procedure or service.
• The amount your insurance plan is expected to pay.
• Your expected out-of-pocket expenses.

Knowing the estimated cost of your medical services in advance can relieve a significant burden from your shoulders. It allows you to plan ahead, explore your financial options, and avoid unpleasant surprises when the bills arrive or when asked to pay out-of-pocket expenses at the time of service.

Billing Terms

We know that there are a lot of billing terms that may be confusing to patients.  Here is a quick glossary of terms you may encounter on your Good Faith Estimate.

Deductible – The amount you pay out-of-pocket before your insurance kicks in.

Copay – The predetermined amount you pay for health care services at the time of care.

Coinsurance – A percentage of your medical charges that you pay, and the rest is paid by your insurance provider. This typically doesn’t apply until after you have met your deductible.

In Conclusion

The Good Faith Estimate is a game-changer for patients and anyone interested in transparent healthcare costs. It’s a big step forward towards a more patient-friendly healthcare system. Don’t hesitate to ask your doctor for a GFE, and start taking charge of your healthcare expenses with confidence. After all, your well-being shouldn’t come with hidden costs!

Remember, you have the right to clear and upfront information about your medical expenses, so go ahead and ask for your Good Faith Estimate – it’s a friendly tool designed to make your healthcare journey smoother.

Schedule Your Visit

Via the Patient Portal

This information is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice.  Should you have any questions or would like to discuss an upcoming office visit, please contact the staff at Parveen S. Vahora, MD.  We are here to help.