Automate detection of No Surprises Act GFE compliance gaps by auditing scheduling and financial counseling system event logs

Verified steps

1. Export scheduled appointment records from the scheduling system, filtering for self-pay and uninsured patients whose services are scheduled 3 or more business days in advance.
2. For each qualifying appointment, query the financial counseling or patient access system to retrieve the timestamp of GFE issuance (if recorded) and the delivery method.
3. Compare the GFE issuance timestamp to the scheduling timestamp: for services scheduled 3–9 business days out, the GFE must have been issued within 1 business day after the scheduling date; for services scheduled 10 or more business days out, within 3 business days after scheduling.
4. Flag records where no GFE was issued, where the GFE was issued outside the required window, or where the GFE is missing required fields (co-provider charges, billing codes, expected collection amount).
5. Produce a compliance summary report by department and scheduling user, identifying the rate of GFE issuance compliance, average delivery time, and most common failure modes.
6. Integrate the audit into a recurring workflow that runs weekly so that compliance gaps are identified before they accumulate into systemic violations.