What the No Surprises Act Means for the Healthcare Community
The No Surprises Act came into effect from January 2022. The Consolidated Appropriations Act of 2021 had the No Surprises Act as part of the bill to protect patients and improve directory information accuracy.
The No Surprises Act came into effect from January 2022. The Consolidated Appropriations Act of 2021 had the No Surprises Act as part of the bill to protect patients and improve directory information accuracy. This law announced a new set of guidelines for health insurance issuers that offer group or individual health insurance coverage to mandate the following.
The new law does not pre-empt any of the existing state laws and will not apply to stand-alone dental care plans. Also, Providers and facilities need to communicate changes about their provider directory information to health plans and insurers within a specific time period. The collective goal is to have Insurers and providers work cohesively in order to improve the provider information accuracies in public-facing directories and other relevant materials
What is a Surprise Medical Bill?A Surprise medical bill occurs when an insured patient receives care at an in-network facility, however providers who treat the patient are not in the patient’s insurance network. Surprise medical bill can also occur when an insured patient receives emergency care at an out-ofnetwork facility. |
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1 in 5 Americans has received a surprise medical bill from an emergency department visit |
2 of 3 Americans say they are concerned about the affordability of unexpected medical bills and nearly half of them can’t afford to pay surprise bills in full |
Introducing the No Surprises Act The No Surprises Act, which took effect on January 1, 2022 aims to strike a balance in the inequities |
Source: Kaiser Family Foundation |
Healthcare consumers are most likely to bear the brunt of these complexities involved in provider directory misinformation.
Improve Data Accessibility Across the Organization. Care providers need to implement new solutions that make data exchange and accessibility simple across the organization. Hospitals can consider integrating automation solutions to enhance efficiencies and improve data accuracies. Hospitals use next-gen technologies and strategies to gather high-value patient data. Patient Reported Outcomes (PRO), Patient Generated Health Data (PGHD), Social Determinants of Health (SDOH) and other data are seamlessly gathered to deliver personalized recommendations and timely interventions. These strategies need to be used in insurance data in order to improve team efficiencies and data accuracies to mitigate the impact of Surprise billing.
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