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Convening Provider Estimate Support

About Convening Provider Estimates

The No Surprises Act (NSA) is a federal law created, in part, to reduce or eliminate surprise medical bills received by patients. Under the NSA, Good Faith Estimates (GFEs) should be delivered to self-pay patients when their care is scheduled 3 or more days in advance. 

The NSA requires convening facilities to provide a single, combined GFE including all facility charges and professional charges, even if those charges will be billed separately. The convening provider is responsible for combining its facility estimate with the estimated charges of all other professionals expected to provide services and delivering the combined GFE to each self-pay patient with care scheduled 3 or more days in advance.
  
For Vanderbilt professionals providing services at your facilities, you will need VUMC’s estimated charges to include in combined GFEs for self-pay patients. As you prepare combined GFEs for self-pay patients, you can obtain the estimated charges for services provided by our professionals through VUMC’s online estimate tool.

Get Started with the Vanderbilt Shopper Estimate Tool

  1. Gather the necessary information. You will need the CPT code or codes. And, you will need to know if the fee is for a Vanderbilt surgeon, anesthesiologist or rounding provider.
  2. Visit the Estimate Tool and accept the disclaimer at the bottom of the screen. The disclaimer explains that the estimate will only be as accurate as the information you put in. For several reasons, the patient’s final cost may be a little different than the estimate.
  3. Select the "Providers Only" button
  4. Type the CPT code in the search box. Each CPT code will include the professional fees from either the rounding provider, the surgeon, or the corresponding anesthesiologist. All estimates include a self-pay discount.

Watch the video below for a walk-through of the estimator tool.

Vanderbilt Health Estimator Tool