Good Faith Estimate Software for No Surprises Act Compliance in 2026

We are now more than four years into the enforcement of the No Surprises Act. Federal enforcement has so far emphasized complaint investigations and documentation requests rather than financial penalties, but the Centers for Medicare and Medicaid Services (CMS) continues to investigate consumer complaints, and the pressure on providers has not eased.

Some of the earliest signals came from law firms reporting that CMS had sent letters to hospitals requesting documentation on procedures and pricing. That posture has held: lawyers still advise their hospital clients to prepare for these letters, and CMS maintains a robust Help Desk that walks consumers through filing a complaint. The Help Desk asks patients to submit documentation (good faith estimates, bills, and more), processes complaints, and keeps consumers updated on their progress.

These document requests sit at the leading edge of a broader complaint trend. Americans are not shy about disputing charges they feel are inaccurate or unfair. Below, you will learn how providers are putting good faith estimate software to work to stay compliant with the No Surprises Act without bringing on additional staff.

Key takeaways

• Good faith estimate (GFE) software creates, sends, and tracks No Surprises Act-compliant patient estimates, often with pay-now links that capture deposits before service.
• The federal penalty for non-compliance reaches up to $10,000 per violation, and any bill that lands more than $400 above the estimate can trigger a patient dispute.
• Accuracy is the differentiator that matters most. Estimates built from averages put you at compliance and revenue risk, while charge-level calculations hold up against the final bill.
• Patients now owe a larger share of every bill while collection rates fall, so estimating accurately and collecting upfront protects revenue that would otherwise slide into bad debt.
• Clarity Flow from MD Clarity pairs a charge-level pricing engine with touchless delivery and upfront payment capture.

The first organizations forced to comply with the No Surprises Act

When the No Surprises Act passed, healthcare organizations that serve large populations of uninsured and self-pay patients faced the prospect of compiling thousands of good faith estimates. That shift would normally require hiring several new revenue cycle FTEs. Given a widespread staffing shortage, new hires are not only hard to find, they are expensive. Many organizations, even those that mostly bill insured patients, turned to software to handle this part of their revenue cycle.

One of them, a women's healthcare group with 35 clinics across six Midwest states, faced hiring four to eight additional FTEs to research, compile, and generate 445 GFEs a day. After a long vetting process, they chose a good faith estimate software solution that, in addition to those three tasks, could automatically send estimates to the vast majority of their patients at scheduling. They also prioritized estimate accuracy, since any charges that come in $400 over the estimate can be disputed. Once the program was live, 99 percent of their estimates reached patients without any staff intervention, and the group has stayed compliant with the No Surprises Act ever since. Hiring those additional FTEs would have cost an extra $172,000 to $344,000 per year.

Curious how good faith estimate software keeps organizations compliant with the No Surprises Act while lifting upfront collections? Walk through a demo of how the software automates the process.

What is good faith estimate software?

Good faith estimate software is a tool that uses automation to research payer policies, run eligibility verifications, generate accurate patient estimates, and (depending on the vendor) send texts or emails detailing a patient's financial responsibility. A good faith estimate includes a clear breakdown of deductibles, copays, and coinsurance. Depending on the vendor, it may also include a link to the provider's portal where the patient can leave a deposit.

Healthcare providers and practices use good faith estimate software, also called patient cost estimation software, to boost upfront collections and improve the patient experience.

On January 1, 2022, the No Surprises Act began requiring providers to issue good faith estimates (GFEs) to uninsured and self-paying patients so they are not caught off guard by unexpected medical bills.

Creating, managing, and sending good faith estimates is easier said than done. The No Surprises Act sets out detailed requirements for what a GFE must contain. It must list the primary items and services along with items reasonably expected to be provided, and it must carry several disclaimers and notifications. There are also strict time frames for delivering GFEs to uninsured and self-paying patients.

All of this means real work for your revenue cycle staff. CMS itself estimates that researching, generating, and sending one estimate manually takes the average employee 1.3 hours. Sending just five a day adds 6.5 hours of work, close to another full employee.

Curious about how good faith estimate software keeps healthcare organizations compliant with NoSA and increases their upfront collections? Walk through a demo of how this powerful software tool automates that process here: 

Good faith estimate software offers a faster, more reliable way to generate, send, and manage fully compliant GFEs. The rest of this guide covers what the tools do, how they help you comply with the No Surprises Act, how the leading options compare, and how the right platform improves your revenue cycle.

Good faith estimate software compared

The right tool depends on your patient volume, specialty, and existing systems, and on whether you need a basic GFE checkbox or a platform built for estimate accuracy and upfront collections. Below is a closer look at the leading options, the methodology behind the ranking, and where each one fits.

Methodology

We evaluated each vendor against six weighted criteria, tuned for a good faith estimate use case where compliance and accuracy carry the most risk:

• Estimate accuracy (25%). Real-time eligibility, contracted-rate logic, deductible and out-of-pocket tracking, and support for multi-component procedures.
• No Surprises Act compliance (20%). GFE generation with all required elements and disclaimers, delivery inside the legal deadlines, and audit trails.
• Automation and delivery (20%). Auto-generation, multi-channel delivery by text, email, or mail, deposit capture, and automated benefit verification.
• Integration breadth (15%). EHR and practice management coverage, payer connections, and API availability.
• Patient experience (10%). Plain-language estimates, mobile-friendly delivery, and self-service payment.
• Reporting and ROI evidence (10%). Analytics, KPI dashboards, published case studies, and third-party validation.

Inputs included vendor product documentation, public CMS guidance, third-party research from KLAS Research and Black Book, peer reviews on Capterra and G2, and published customer case studies. Where a GFE tool is bundled inside a broader revenue cycle or engagement suite, we evaluated the estimate and GFE module on its own merits rather than the parent platform.

1. MD Clarity (Clarity Flow)

Clarity Flow earns the top spot because it was purpose-built for patient cost estimation rather than retrofitted from a clearinghouse or general RCM suite, and that focus shows up in the accuracy of the estimate itself. Its pricing engine simulates how payers actually adjudicate claims, building the estimate from charge-level detail upward and accounting for modifiers, locality adjustments (including GPCI), bundled services, multiple-procedure reductions, and the lesser-of clauses that quietly break simpler estimators. The result lands close to the final adjudicated bill, which is exactly what keeps you clear of the $400 dispute threshold.

That accuracy carries the rest of the workflow. Clarity Flow digitizes payer contracts and fee schedules through self-service import or full-service onboarding, pulls real-time deductible, copay, coinsurance, and out-of-pocket data into every estimate, and auto-delivers branded estimates with the required No Surprises Act language and a pay-now link by HIPAA-secure email or text. MD Clarity reports the touchless approach reduces manual estimate work by 95 percent or more, while exception-based worklists flag only the estimates that need a person. Every estimate is fully auditable down to the charge-by-charge build, and the same engine powers a GFE workflow with built-in timelines, disclaimers, and audit trails. For organizations that also want to recover revenue on the back end, RevFind runs on the same engine to surface underpayments, denials, and contract mismatches.

Best for: Health systems, ambulatory surgery centers, MSOs, and growing physician groups that want the most technically accurate GFEs available, automated compliance, and a clear path from pre-service estimate to upfront payment.

2. Rivet Health

Rivet's patient pricing is a modern, easy-to-deploy option for ambulatory and specialty practices that find hospital-grade estimators too heavy. Estimates generate in seconds, reach patients by HIPAA-compliant text or email, and prepayment is one click away, with estimation tied to current deductible and out-of-pocket status. Practices report rolling it out across staff quickly without formal training, which makes it a strong fit for groups that want estimates live fast.

Best for: Specialty groups and ambulatory practices that prioritize fast deployment and a patient-friendly interface.

3. Panacea

Panacea's patient estimation system sits inside a broader CMS price transparency suite and is built for hospitals that need itemized, line-level GFEs. It combines hospital and physician charge data to produce all-inclusive estimates and also handles machine-readable files and shoppable-services lists, and several of its modules carry HFMA Peer Review recognition. Panacea does not publicly disclose EHR or practice management integrations, so it is usually chosen for its pricing and transparency depth rather than embedded workflow.

Best for: Hospitals that need itemized GFEs as part of a wider price transparency and chargemaster program.

4. DrChrono

DrChrono builds estimates into its EHR, so practices already on the platform can generate and present a GFE inside the same workflow they use for charting and billing. Estimates are fee-schedule based and tie into integrated patient payments, which keeps the experience simple for smaller practices that prefer to run on one system.

Best for: Practices already on DrChrono that want GFEs handled inside their EHR.

5. Jane

Jane embeds estimate and billing tools in its practice management platform, which is popular with allied health and smaller clinics. Estimates draw on fee schedules and connect to integrated payments, making it a convenient option for practices that already run scheduling and billing in Jane and want a lightweight GFE step.

Best for: Allied health and smaller practices already using Jane for scheduling and billing.

6. DoctorConnect

DoctorConnect pairs good faith estimates with patient engagement and revenue cycle tools such as reminders, eligibility verification, and two-way messaging, and emphasizes broad EHR and practice management integration. Practices that want estimates delivered alongside outreach and scheduling in one platform are its core audience, though the GFE itself is one feature inside that wider suite.

Best for: Practices that want GFEs bundled with patient engagement and RCM in a single platform.

How good faith estimate software helps you comply with the No Surprises Act

GFE software helps you on three fronts.

Create compliant GFEs

First, GFE software helps you create estimates that carry all of the required information, disclaimers, and notifications. A compliant GFE includes:

• Patient name and date of birth
• A description of the primary item or service and its scheduled date
• An itemized list, grouped by provider and facility, of items and services reasonably expected for the primary item or service, including supplies, tests, prescription drugs, encounters, facility fees, and equipment
• Items and services reasonably expected to be furnished by co-providers and co-facilities
• Expected charges, service codes, and applicable diagnosis codes for each item or service. Expected charges are the cash-pay rates a provider sets for an uninsured or self-pay individual. Service codes describe an item or service using NDC, HCPCS, DRG, and CPT code sets, and diagnosis codes use the ICD code set
• The state and location where each item or service will be provided
• The name, National Provider Identifier, and Tax Identification Number of each provider or facility on the GFE
• A list of items or services that may need separate scheduling, with a disclaimer noting that codes and identifiers for those items will follow in separate GFEs once the patient schedules or requests them
• A disclaimer that the GFE is only an estimate and that actual items, services, and charges may differ
• A disclaimer that additional recommended items or services not reflected in the GFE may need to be scheduled separately
• A disclaimer that the GFE is not a contract and does not require the patient to obtain services from any listed provider or facility
• A disclaimer explaining the patient's right to start the patient-provider dispute resolution (PPDR) process if actual charges exceed the estimate by more than $400

Streamline eligibility verification

While GFEs mainly apply to uninsured and self-paying patients, the rules get complicated. A careful GFE solution streamlines the work of identifying which patients need an estimate, so no one slips through.

Automatically send GFEs in digital and physical formats

GFE software can deliver estimates by text, email, and postal mail. That helps you meet the No Surprises Act requirement that patients be able to request a GFE on paper or electronically, and in some cases by phone.

Auto-send also helps you hit the law's tight delivery windows. You must provide a GFE within one business day of a request or of scheduling a primary item or service, and within these windows:

• When a service is scheduled at least three days out, send the GFE no later than one business day after scheduling.
• When a service is scheduled at least 10 days out, send the GFE no later than three business days after scheduling.
• When a patient simply requests a GFE, send it no later than three business days after the request.

Where the rules stand in 2026

Two points are worth knowing for 2026. The consolidated GFE requirement, which would have convening providers fold in estimates from co-providers and co-facilities, remains under enforcement discretion, so the immediate obligation centers on the GFE for the items and services a provider furnishes directly. And the advanced explanation of benefits, the parallel estimate for insured patients, has not yet taken effect while CMS works toward a rule. The uninsured and self-pay GFE requirement, however, is fully in force.

Not all good faith estimate software is the same: moving past averages and napkin math

As with most things, not all GFE software is equal. Free tools in particular tend to generate basic templates and lean on simple averages for procedures, glossing over the subtleties of medical billing. That can produce inaccurate estimates and billing discrepancies. Ballpark numbers put you at risk of falling out of compliance and of frustrating patients.

Inaccurate estimates can be costly because of disputes

Inaccurate estimates and billing discrepancies are not just irritating to clean up, they can be expensive because of disputes.

As noted above, patients can dispute charges that come in more than $400 above the figures in their GFE. They can request a determination through the No Surprises Act's patient-provider dispute resolution (PPDR) process for the amount they should pay. The PPDR process can apply to any item or service furnished by a convening provider, facility, co-provider, or co-facility when total charges run $400 or more over the estimate.

This is where accuracy earns its keep. An estimate calculated from a provider's actual contracted rates at the charge level, the engine behind Clarity Flow, lands close to the final bill, which keeps disputes rare and collections clean.

How good faith estimate software improves your revenue cycle

Beyond avoiding inaccurate estimates, compliance gaps, and billing discrepancies, providers use automated GFE software to strengthen the revenue cycle. In particular, leading tools drive upfront and point-of-service collections.

This figure still surprises longtime providers: patients are now responsible for roughly 30 percent of provider income.

Seven to 10 years ago, when patient responsibility sat closer to 10 percent, many organizations sent a couple of bills and let the rest go. High-deductible health plans and medical consumerism ended that. The average single-coverage deductible reached $1,886 in 2025, up 43 percent over the past decade, so patient balances keep climbing.

Providers are also simply collecting less of what they are owed. Kodiak Solutions' 2026 analysis of 2,300 hospitals found that health systems collected just 42.4 percent of patient-responsibility balances in 2025, down from 45.1 percent in 2024, even as patients owed a larger share of net revenue. The collection rate on commercially insured patients had already slid from 37.6 percent in 2023 to 34.4 percent in 2024. All told, the hospitals in Kodiak's analysis left more than $48 billion in net revenue on the table in 2025, a 25 percent jump in a single year.

Providers are paying attention. Forty-eight percent of the healthcare professionals in a 2024 Salucro survey named patient collections their biggest concern. With denials having dominated the conversation for years, patient non-payment has become just as urgent.

It adds up to the most medical debt in U.S. history. KFF polling finds that 41 percent of adults carry health care debt, the highest level on record. The question for every organization is how to stay viable when the patient has become a major payer.

Two upfront collections case studies

A couple of case studies show what happens when organizations insist on upfront payment.

Health First Hospital in Florida pushed harder on upfront collections by making sure every patient received a cost estimate before service. That lifted upfront collections by 27 percent and produced 2.7 percent net revenue from point-of-service collections, well above the 0.7 percent industry standard. Health First hit a record share of revenue collected upfront and added $2 million in upfront collections for the year, along with higher patient satisfaction.

A small hospital in Illinois saw a 300 percent increase in point-of-service collections by insisting on upfront payment of patient balances, sailing past its $7,000 monthly target for all point-of-service payments, including walk-ins.

When you trust your GFEs, you are more comfortable taking payment upfront, because you know the final bill will land at or near the estimate. Patients, especially returning ones, are also more comfortable paying when they see a thorough estimate. Research from InstaMed shows 80 percent of patients want to know their financial responsibility before treatment. As they shoulder more of the cost, patients increasingly value clear pre-service numbers, and providers are getting better at opening these conversations without making them confrontational.

Upfront and point-of-service collections plus precise estimates equal happy patients and stronger revenue

When automated GFE software captures more revenue upfront, secondary benefits follow.

Lower accounts receivable days and bad debt

Every dollar collected upfront stays out of accounts receivable and out of write-offs.

More patient loyalty in an age of healthcare consumerism

Patients increasingly compare reviews of physicians, clinicians, and facilities, looking for the best care at the best price. In one survey of 990 patients, 90 percent used online reviews to evaluate physicians and 71 percent used them as the very first step in finding a new doctor. Financial factors increasingly show up in those reviews, because consumers want to know what a procedure will cost before they commit. You can review the ways to make cost conversations a positive and reassuring experience in a recent blog post.

Cost of good faith estimate software

Good faith estimate software usually carries variable pricing driven most heavily by patient volume. The more patients an organization sees, the higher the cost, which lets the software scale up or down to fit a practice's needs. Smaller practices pay less than larger ones, and at any size, software is almost always far cheaper than hiring new FTEs.

It also helps you avoid the No Surprises Act's fines of up to $10,000 per violation, a cost that dwarfs most software budgets.

Automate good faith estimates and collect upfront with MD Clarity

Good faith estimate software lets you create, manage, and send No Surprises Act-compliant GFEs to uninsured and self-pay patients. It also streamlines eligibility verification, delivers estimates in digital and physical formats, and strengthens your revenue cycle.

Intuitive, reliable, and streamlined, our Clarity Flow good faith estimate software helps organizations stay compliant with the No Surprises Act and put accurate estimates in patients' hands. With Clarity Flow, providers can create, automate, and deliver estimates by mail, email, and text, and collect upfront deposits directly from online estimates.

Book a demo today to experience the Clarity Flow difference.