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Text of CMS Standard Form: 'Good Faith Estimate for Health Care Items and Services' Under the No Surprises Act (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] 
[Official Guidance] June 7, 2023 12 pages. "This form may be used by the health care providers and facilities to inform uninsured (or self-pay) individuals of the expected charges for receiving certain health care items and services.... HHS considers use of the model notice to be good faith compliance with the good faith estimate requirements to inform an individual of expected charges. Use of this model notice is not required ... [A] good faith estimate that meets all of the requirements under 45 CFR 149.610 is necessary in order to begin the patient-provider dispute resolution process." MORE >> |
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