Navigating the Good Faith Estimate for Outpatient Therapy Services
Presented by Rick Gawenda
This course will teach participants what the good faith estimate (GFE) is, which insurance carriers and patients the GFE applies to, how it applies to cash-based therapy practices, and what the required elements of a GFE are. It will also explain the patient–provider dispute resolution process.
Learning Objectives
- Apply the various definitions associated with §149.610 requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) individuals
- Choose the timeframes in which a GFE must be provided to an individual
- Determine the required elements that must be included in a good faith estimate
- Solve how a GFE can be delivered to an uninsured/self-pay individual
- Apply the patient–provider dispute resolution process
- Distinguish situations when a GFE may need to be issued to a patient inquiring about and/or receiving outpatient therapy services
Meet your instructor
Rick Gawenda
Rick Gawenda is founder and president of Gawenda Seminars & Consulting, Inc. He graduated in 1991 with a Bachelor of Science in physical therapy from Wayne State University in Detroit. Rick is director of finance for a physical therapist–owned private practice with multiple offices located in Southern California. In addition,…
Chapters & learning objectives
1. Definitions Associated With the GFE
This chapter will teach the participants the definitions of applicable terms needed to understand the good faith estimate requirements.
2. Requirements and Timeframes
This chapter will teach participants the requirements of a provider and facility regarding the GFE as well as the timeframes in which a GFE must be given to a patient.
3. Required Elements of a GFE
In this chapter, viewers will solve how a GFE can be delivered to an uninsured/self-pay individual.
4. Patient–Provider Dispute Resolution Process
This chapter will teach participants the patient–provider dispute resolution process when the actual charges are $400 or more than the expected charges detailed in the GFE.
5. Situations That May Require a GFE to Be Issued
This chapter will teach participants possible scenarios when a GFE may be required to be issued to a patient inquiring about and/or receiving outpatient therapy services.
More courses in this series
Navigating the Good Faith Estimate for Outpatient Therapy Services
Rick Gawenda
How to Use the ABN for Outpatient Therapy Services
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Introduction to the PT Evaluation Codes
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The Medicare Annual Therapy Dollar Threshold and MPPR
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OT Evaluation Codes: Case Scenarios
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PT Evaluation Codes: Case Scenarios
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