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OMB Control Number: 0938XXXX Expiration Date: xx/xx/XXX APPENDIX 11 Good Faith Estimates Data Elements The Departments of the Treasury, Labor, and Health and Human Services (collectively, the Departments)
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What is good faith estimates?
Good faith estimates are written estimates provided by healthcare providers or facilities to inform patients about the expected costs of a proposed treatment or service.
Who is required to file good faith estimates?
Healthcare providers and facilities that are not participating in a patient's health plan must provide good faith estimates to uninsured patients or those who are not using their insurance.
How to fill out good faith estimates?
Good faith estimates should include detailed descriptions of the items or services being proposed, their expected costs, and any potential out-of-pocket expenses the patient may incur.
What is the purpose of good faith estimates?
The purpose of good faith estimates is to provide transparency in healthcare pricing, allowing patients to understand and budget for the costs of their healthcare services.
What information must be reported on good faith estimates?
Good faith estimates must report the description of services, expected charges, any applicable discounts, and provide a disclaimer about the estimate being subject to changes based on the actual services rendered.
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