Good Faith Estimate Form
Answered
Starting January 1 there is a new federal mandate that private pay clients are to receive a Good Faith Estimate of the nature of services and cost of them. Requirements include:
Here is a list of what belongs in the GFE (which can also be part of an informed consent or disclosure statement) for private practitioners:
- The patient’s name and date of birth;
- A description of the psychotherapy or other service(s) being furnished to the patient;
- An itemized list of items or services that are “reasonably expected” to be furnished;
- Expected charges associated with each psychotherapy session or other service(s);
- Your name, National Provider Identifier, Tax Identification Number, office location where services will be provided;
- A disclaimer that there may be additional items or services that you recommend as part of the treatment that will be scheduled separately and are not reflected in the good faith estimate;
- A disclaimer that the information provided in the good faith estimate is only an estimate and that actual items, services, or charges may differ from the good faith estimate; and
- A disclaimer that the good faith estimate does not require the private pay patient to obtain psychotherapy or other services from you.
This information can be transmitted orally but should be given to the patient as soon as possible.
Does anybody have a good form for this mandate?
Joel
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My understanding is that the client must receive this before any services take place. As an assessment, GFE form is in the client's chart but the client can't view it. How can we get it over to the client prior to their first session? Is there any way to make this fillable form one that's sent during the on-boarding process (like we send the Informed Consent form, etc.)?
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Hi Sara,
The Good Faith Estimate for Health Care Items and Services that SP provides is quite good. As Joel, Aimee and Erika mentioned it is for clinician use and in Assessments. Any way to have the form tweaked to be included with initial paperwork from clinician to client?
Thank you everyone!
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This form is a great start, however as others have said, most of the information would really need to autofill/the financial information will need to be filled in by the clinician. This estimate will also be different for each individual patient. Any way to automate this would be so helpful, thanks!
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Hi,
Yes I see the form template, which is SUPER helpful given all the confusion and misinformation on our own in creating templates. But as a few others said - the template form created by simple practice is only editable by the client (like the ROI), and it is actually necessary that the clinician edit it before sending it out to client who simply reviews and then signs.
Can we make it editable from the clinician? I can make it a drop down/answer form myself if it's not able to autopopulate with client information (name/DOB), and anticipated service code(s)/fee(s) and diagnoses, but as of now the clinician cannot edit it prior to sending to client - so it's all left blank for the client to complete which isn't possible given the nature of the information.
Thank you!
Sarah -
I did a "test" GFE under a fake client name. I then completed it (as much as I could but I still have a LOT of questions on how to correctly fill out), and signed it. When I chose the "print" option, one area in particular did not auto populate! And that section was not fillable when doing the form..... see below, the printable form the client would receive...
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Hi everyone,
For all of these requests on how to improve the current assessment we offer and ideas on what you would like to see, I recommend adding these comments to this Ideas and Suggestions Board post: https://simplepractice.uservoice.com/forums/918553-simplepractice-feedback/suggestions/44599761-autogenerate-good-faith-estimate Our Product Team is actively looking for feedback and suggestions on how we can best assist our customers with this and they will be gathering that information from comments made on our Ideas and Suggestions Board to make improvements.
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How about that Stripe fee report we've been asking about for a year?? You guys claim you listen to your users, but you do not include simple reports that would simplify (part of your name) and streamline using your system. The more requests like this go unanswered, the less confidence your users have in your willingness to improve in meaningful ways for them. I realize the law just passed on Dec 27th, but it was in the works for two years. Will there be automation on the GFE or not? Please provide a yes or no answer ASAP so we can plan accordingly. Thank you.
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Hi everyone,
Yes, this form is something that our Product Team is currently working on changing and improving as they are aware of the discussion around its currently functionality. Our Team has been working very diligently on completing many of the requested features on our Ideas and Suggestions Board and consistently updates the statuses on these posts to keep our customers updated with when features will be released. We have many highly requested and exciting features coming your way in 2022 that we can't wait to begin announcing very soon thanks to the feedback we have received on the Ideas and Suggestions Board.
Additionally, we have released a new Pollen article to help answer some questions about the No Surprised Act: https://www.simplepractice.com/blog/no-surprises-act-good-faith-estimates/?fbclid=IwAR22rBOhZMwZVEWTY1fKOOI4BWpDJ5MpKafy8z915iwjwjhi9AY3KSbz1bs
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