Good faith estimates
How do we build and deliver a good faith estimate to an uninsured or self-pay patient on the No Surprises Act clock, with the delivery recorded?
Start the estimate from the booking and deliver it before the deadline by rule. When an uninsured or self-pay service is scheduled or a patient asks for an estimate, Callvu prefills the patient and the service (the primary items and the expected co-providers, the diagnosis and the service codes, the setting), classifies the request by its timing (scheduled at least three or ten business days out, or an unscheduled request) to set the delivery deadline, builds the estimate from the charge master and the cash prices with the required contents (the itemized expected charges, the providers, the disclaimers), delivers it in the patient's chosen form, records the delivery date and the version, and writes the estimate to the billing system so the final bill can be compared to it under the dispute rules.
In scopeComplex: multi-party handoffsCallvu moves: prefill, classify, write back
Last updated November 7, 2026.
The problem today
The patient asked for an estimate on a Monday; the service was Thursday; the estimate was mailed the following week.
Since 2022, uninsured and self-pay patients are entitled to a written good faith estimate before scheduled care, on a clock measured in business days from scheduling or from the request, with the items and the providers listed. Most providers built it as a manual task for the financial counselor: look up the codes, call the charge master, type a letter. It arrives late or not at all, and a bill that exceeds the estimate by the threshold is open to the patient-provider dispute process.
The rule is specific: the deadline depends on when the service was scheduled relative to the date (three business days after scheduling when the service is at least ten business days out, one business day when it is at least three, and three business days after a request), the contents are prescribed (the patient, the services and codes, the expected charges, the providers and facilities, the disclaimers), and the estimate must be kept for six years. The data is in the scheduling and the charge master; the clock is the hard part.
An estimate that builds itself from the booking is on time by construction.
How it runs
From the requestto the system of record.
An uninsured or self-pay service is scheduled, or a patient asks for an estimate, in any channel. Callvu opens the estimate with the deadline computed.
- Patient
- Chooses how to receive the estimate, receives it, and can ask questions or request an update.
- Scheduling and financial counseling
- See the estimate's status and handle questions.
- Co-providers
- Supply their expected charges where the convening provider must include them.
- Callvu
- Prefills, classifies the timing, builds, delivers, records and writes.
Prefill and classify the timing
The patient, the self-pay status, the scheduled service with its codes and setting, the expected items and co-providers are prefilled from scheduling and the EHR; the request is classified by its timing (scheduled at least ten business days out, at least three, or an unscheduled request) and the delivery deadline is computed in business days.
Build the estimate
The expected charges for each item and service are pulled from the charge master and the cash price list (with the self-pay discount applied where the policy provides), the co-providers' expected charges are requested through their links where the rule requires their inclusion, and the estimate is assembled with the prescribed contents: the patient's details, the services and codes, the itemized expected charges, the providers and facilities, the disclaimers about the estimate's scope and the dispute process.
Deliver on the clock
The estimate is delivered in the form the patient chose (electronically or on paper) before the deadline, with the delivery date, the method and the version recorded; a change in the service or an added item generates a new version delivered on the same rules.
Write back
The estimate with its version, the delivery record and the retention date are written to the billing system and attached to the account, so the final bill is compared to the estimate and a bill above the dispute threshold is flagged before it goes out; the back office report shows estimates due, delivered and late.
Where it ends: Every uninsured or self-pay booking produced an estimate with the required contents, delivered before the rule's deadline, recorded with its version, and attached in the billing system for the comparison the dispute rules require. The Decision Trace shows the timing classification and the charges' sources; the Audit Trace shows the build, the delivery and the write with time.
Runtime enforcement
What is enforcedwhile the work runs.
The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.
The handoff
Between the front doorand the back office.
The front door
The booking in any channel or the patient's request; the patient chooses the delivery form.
The back office
Financial counseling sees status and handles questions; billing compares from the record.
The Decision Desk
- A service the charge master cannot price, a co-provider who does not respond, or a bill above the dispute threshold goes to the financial counseling lead in the Decision Desk with the estimate and only the allowed outcomes.
Proof
In scope.Proof at scale, not one process at a time.
The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.
23 hospitals in the Ministry of Health network run on Callvu.
Across Callvu customers
More than 1,000 processes are live across Callvu customers.
Across Callvu customers
Questions
What buyers ask next,answered plainly.
When is the estimate due?
Within one business day of scheduling when the service is at least three business days away, within three when it is at least ten, and within three business days of a request; the process computes the deadline from the booking.
What must it contain?
The patient's details, the services and codes, the itemized expected charges, the providers and facilities, and the required disclaimers, in the form the patient chose.
What happens if the bill is higher?
The billing system compares the bill to the estimate on file and flags one above the dispute threshold before it goes out, since the patient may start the dispute process within 120 days.
Related processes
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