Good Faith Estimate

1. The Good Faith Estimate (GFE) feature helps providers generate estimated service cost documents for uninsured or self-pay patients. The estimate includes expected charges, provider details, itemized services, and required disclaimers before treatment is provided.
2. The generated GFE document can be shared with patients through the Patient Portal or email and stored securely within patient records.

Identify Eligible Patient

1. Begin by opening the required Patient Profile and verifying whether the patient is marked as:
   • Uninsured
   • Self-pay
2. If the patient qualifies under either category, proceed with creating the Good Faith Estimate.

Assign Provider & Service Codes

1. Open the Patient Chart and select the appropriate provider responsible for the visit.
2. Add the required:
   • Diagnosis Codes (ICD-10)
   • Service Codes (CPT / HCPCS)
3. These codes are used to build the estimate and calculate the projected patient cost.

Create Good Faith Estimate

1. Navigate back to the Patient Profile and click on the Insurance Coverage tab, then open the Good Faith Estimation tab.
2. Click the “+ Create Estimate” button to begin creating the Good Faith Estimate document.
3. Enter the required basic details including:

• Title
• Date
• Service Date

4. The Expiration Date is automatically set to 12 months from the created date.

Provider Details

1. Select the required provider. If a primary provider is assigned to the patient, the system automatically selects that provider by default.
2. Related provider information such as:

• NPI Number
• Facility Details – are automatically populated by the system.

Add Services & Costs

1. In the Services Table, add the required service details for the estimate.
2. For each service:

• Select CPT / HCPCS Code
• Service Description auto-populates
• Enter Quantity
• Fee Schedule auto-populates and remains editable
• Select Diagnosis Code

3. The system automatically calculates the Total Cost using:

• Quantity × Fee Amount

Additional Actions

1. Click “+ Add Service” to include additional services in the estimate.
2. Use the Delete icon to remove unwanted service rows.
3. Additional comments or instructions can be entered in the Additional Notes section.

Save & Generate Document

1. After entering all required information, click “Save” to generate the Good Faith Estimate document.
2. The system automatically creates the GFE document including:

• Provider Information
• Itemized Service List
• Estimated Total Cost
• Required Legal Disclaimers

3. The document is generated in PDF format for sharing and storage.

Send Estimate to Patient

1. After generating the estimate, click “Save” to share the document.
2. Available delivery methods include:

• Patient Portal
• Email (optional)

3. Patients can:

• View the estimate
• Review service details
• Sign the document electronically using the signature field provided

View Saved Documents

1. All generated Good Faith Estimate documents are stored within the patient record.
2. Navigate to:

• Patient Profile
• Documents Tab

3. Providers can manage saved estimates using the available actions:

• View
• Print
• Download PDF
• Delete

4. Click the three-dot menu to access document actions.

Patient Document Storage

1. Once shared, the Good Faith Estimate document is automatically saved in the patient’s document records as a PDF file.
2. If the estimate is re-sent or regenerated, the latest version replaces the previously shared document.

Provider Review

1. Providers can verify completed estimates and patient signatures from the shared document section.
2. Open the shared document and review:

• Patient Signature
• Estimate Details
• Service Information