Details
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Change Request
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Resolution: Persuasive
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Medium
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US Da Vinci Patient Cost Transparency (PCT) (FHIR)
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0.1.0 [deprecated]
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Financial Mgmt
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PCT Good Faith Estimate Institutional
PCT Good Faith Estimate Professional -
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Rick Geimer/Paul Knapp: 9-0-1
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Enhancement
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Compatible, substantive
Description
It is possible that a GFE bundle will contain a GFE from an out of network provider whose services are subject to No Surprises Act protections. In that case, the member and the provider may have already agreed to waive balance billing protections.
When that case happens, a flag indicating the agreement may provide payers with more information they can use to help the member understand their full potentially liability for services.