Price Transparency Rules in Action: How Good Faith Estimates Influence Patient Trust & Revenue

With rising healthcare costs and increasing consumer expectations, price transparency has moved from being a compliance requirement to a competitive advantage for providers. At the heart of this transformation is the Good Faith Estimate (GFE)—a key mandate of the No Surprises Act that took effect in 2022. As of 2025, this rule continues to shape how patients interact with providers, particularly regarding trust, financial planning, and decision-making.

In this blog, we’ll explore the importance of Good Faith Estimates, their legal foundation, how they impact patient trust and practice revenue, and what providers should do to stay compliant and competitive.

What is a Good Faith Estimate (GFE)?

A Good Faith Estimate is a written document provided to uninsured or self-pay patients detailing the expected costs of medical items or services. Under the No Surprises Act, providers and facilities must give this estimate before the service is rendered, helping patients make informed choices and reducing the risk of surprise bills.

Key elements of a GFE include:

• Patient’s name and date of birth
• Itemized list of services or procedures
• Estimated cost for each service
• Provider and facility information
• Disclaimers about potential additional charges

Why GFEs Matter: The Patient Perspective

    Clarity and Empowerment

Today’s healthcare consumers are increasingly seeking cost predictability. For many, the fear of unexpected or unaffordable medical bills outweighs concerns about the procedure itself. The GFE provides patients with a clear financial picture, empowering them to:

• Compare costs among providers
• Budget for upcoming treatments
• Avoid surprise medical bills

    Trust-Building Tool

By proactively offering transparent pricing, providers demonstrate honesty and integrity. This transparency builds trust—a critical factor in patient retention and satisfaction. Patients are more likely to return to, and refer, providers who are upfront about costs.

Impact on Practice Revenue: It’s Not Just About Compliance

Many providers view GFEs as a regulatory burden, but done right, they can actually boost practice revenue in several ways:

    1. Reduction in Payment Delays and Bad Debt

When patients are informed about their financial responsibility upfront, they are more likely to:

• Pay in advance or at the time of service
• Enroll in payment plans
• Avoid billing disputes

This helps reduce accounts receivable days (AR Days) and improves cash flow.

    2. Improved Collection Rates

Transparent cost estimates can lead to higher patient collections. With accurate GFEs, there are fewer billing discrepancies and patient complaints, which means fewer delays and disputes over bills.

    3. Operational Efficiency

Standardizing GFE creation using automation or integrated software reduces administrative burden and billing errors. This frees up staff to focus on more valuable revenue cycle tasks, such as appeals, eligibility checks, and coding accuracy.

Legal and Compliance Obligations: Know the Rules

The No Surprises Act mandates GFEs for uninsured and self-pay patients. As of now:

• Providers must deliver the GFE within 3 business days of a scheduled service (or within 1 day for urgent appointments).
• GFEs must include associated services, including anesthesia, labs, and facility fees.
• Patients have the right to dispute bills that exceed the GFE by $400 or more via a CMS-established process.

Failure to comply can result in:

• Fines up to $10,000 per violation
• Audit risks
• Reputational damage from patient complaints or legal action

How to Implement GFEs Efficiently: Best Practices

    1. Integrate GFE into Scheduling and Intake Workflows

Train front desk or intake staff to identify self-pay or uninsured patients during scheduling. Trigger a GFE workflow automatically through your practice management or EHR system.

    2. Automate with Estimation Tools

Use RCM tools or vendor platforms that generate GFEs based on:

• CPT/HCPCS codes
• Fee schedules
• Insurance plan databases

This improves accuracy and ensures consistent formatting.

    3. Keep Estimates Patient-Friendly

Don’t overload patients with jargon. Ensure estimates are written in plain language, with clear explanations of:

• What’s included (and what’s not)
• Payment options
• Possible variations in final charges

    4. Include All Providers in the Estimate

If multiple providers (e.g., labs, anesthesiologists, radiologists) are involved, work with them to coordinate one unified estimate. CMS expects providers to work toward consolidated GFEs in the near future.

    5. Track Discrepancies and Disputes

Set up internal processes to:

• Flag when final charges exceed the GFE by $400+
• Respond to patient disputes within the allowed timeframe
• Audit your estimates vs. actual charges to identify trends

Challenges Practices Face with GFEs

Despite the benefits, many practices still struggle with implementation due to:

• Lack of integrated tools for multi-provider estimates
• Difficulty predicting costs for complex procedures
• Misalignment between billing and clinical staff
• Time constraints in urgent or walk-in care settings

However, these challenges can be mitigated through staff training, automation, and clear policies.

The Future of Price Transparency

As CMS expands its enforcement and additional rules are expected for insured patients, practices that adopt price transparency early will be better positioned for:

• Value-based care participation
• Direct-to-consumer models
• Contract negotiations with payers

Moreover, patients will increasingly favor providers who offer upfront pricing clarity, just like they expect from any other service provider.

Conclusion

The shift toward price transparency, driven by regulations like the Good Faith Estimate, is reshaping how healthcare providers interact with patients. What was once considered just a compliance requirement is now a strategic opportunity to build trust, enhance the patient experience, and improve revenue outcomes.

By embracing transparency, your practice not only reduces the risk of denials and disputes but also positions itself as a patient-first organization—one that respects both clinical and financial wellness. As patients become more discerning and financially involved in their healthcare choices, those providers who lead with clarity, consistency, and communication will stand out in a competitive landscape.