The steps in the examples should be updated as follows:
#4: The next day, Eve calls the radiology facility (Office of Dr. Christine Curie, NPI - 1234567893) to schedule her brain MRI, CPT 70551 and provide her coverage information, which she plans to use” – the scenario speaks to the radiology facility; however the example speaks to a professional – change the example to be a facility.
Modify #7 as follows: The ABC’s Radiology Office Administrator enters the services and coverage information, initiates the process with other potential providers to generate the Good Faith Estimate (GFE) for the expected charges with the expected billing and diagnostic codes.
Modify #9 as follows: The payer receives the GFE. Within one business day the payer adjudicates it and sends the Good Faith Estimates of cost, cost-sharing and progress towards meeting deductibles and out-of-pocket maximums, as well as whether a service is subject to medical management and relevant disclaimers of estimates as an AEOB securely to Eve.
Modify #12 as follows: Optionally, Eve or an authorized user could use their 3rd party app to query for the AEOB via the patient access API (if supported by their payer).