CMS published Guidance on Good Faith Estimates (GFEs) for Uninsured (or Self-Pay) Individuals - Parts 3 and 4. Part 3 clarifies that HHS is extending enforcement discretion, pending future rulemaking, for situations where GFEs for uninsured (or self-pay) individuals do not include expected charges from co-providers or co-facilities. Part 4 provides additional guidance for providers that offer sliding fee discounts as well as additional guidance for providers who do not expect to charge. Additional FAQs related to GFEs for uninsured (or self-pay) individuals are available here.

Ending Surprise Medical Bills

See how new rules help protect people from surprise medical bills and remove consumers from payment disputes between a provider or health care facility and their health plan

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No Surprises Act

Policies & resources

Review rules and fact sheets on what No Surprises rules cover, and get additional resources with more information.

Overview of rules & fact sheets Provider resources Providers: submit a billing complaint Providers: payment resolution with patientsPlans and Issuers resourcesPrivacy policies & notices for this website

Resolving out-of-network payment disputes

Learn about out-of-network payment disputes between providers and health plans and how to start the independent dispute resolution (IDR) process, apply to become a certified independent dispute resolution entity, or submit a petition on an applicant or to revoke certification of a current IDR entity.

Learn about or start a payment disputeTips for disputing partiesBecome a dispute resolution organization List of certified organizations

Submit petition to deny IDRE certification

Submit petition to revoke IDRE certification

Consumers

Learn about rights and protections for consumers to end surprise bills and remove consumers from payment disagreements between their providers, health care facilities and health plans.

For consumers: your rights, protections & resources 
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Page Last Modified:
12/05/2022 11:47 AM
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