Self Pay Balance

Yes, under the No Surprises Act, providers must provide GFEs to uninsured or self-pay patients. Key points include

• Timing: GFEs should be provided upon scheduling services or upon patient request.

• Content The GFE must include expected charges for all scheduled services, even if a diagnosis code is not yet determined.

• Recurring Services: For recurring services, a single GFE can be issued, covering up to 12 months, detailing the scope and frequency of services.

For services scheduled less than three business days in advance, including same-day or walk-in appointments:

• GFE Requirement: Providers are not required to provide a GFE in these situations.

• Best Practices: It's still advisable to inform patients about the estimated costs and obtain consent before proceeding with services.

To enhance collections from self-pay patients, providers can:

• Implement Clear Payment Policies: Establish and communicate written payment policies that outline expectations and procedures for self-pay patients.

• Offer Multiple Payment Methods: Accept various forms of payment, including credit cards, online payments, and payment plans, to accommodate patient preferences.

• Provide Financial Counseling: Assist patients in understanding their financial responsibilities and explore potential assistance programs if needed

• Timely Billing: Issue bills promptly after services are rendered to encourage timely payments.

By adhering to these practices, medical service providers can effectively manage self-pay patient billing, ensuring compliance with regulations and maintaining financial stability

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