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Surprise billing regulations establish procedures to determine out-of-network rates

The second interim final rule implementing the No Surprises Act establishes procedures and timeframes for determining out-of-network payment rates, requires healthcare providers and facilities to inquire about an individual’s health coverage status and provide good faith cost estimates to uninsured and self-insured patients upon request, and establishes a patient-provider dispute resolution process for uninsured and self-pay patients.

The No Surprises Act will take effect in January 2022, so healthcare providers who furnish services at healthcare facilities and bill on an out-of-network basis should start preparing to navigate these changes as well as related state law restrictions now.

Click to read the full article, which includes 9 important action steps healthcare providers should take.