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Are new government regulations really ever a surprise?  To help welcome in the New Year, the federal government is introducing the “No Surprises Act”.  The No Surprises Act is a law establishing federal standards to eliminate surprise bills for insured individuals, self-insured, small groups, and large group markets.  Basically the law focuses on financial protection for patient’s receiving out-of-network services, a dispute resolution process for providers and payers in order to settle payment disputes, and a requirement for provider transparency – meaning providers will have new standards requiring them to “clearly communicate the cost of care” to all patients, insured and uninsured.

For providers this will not only mean written estimates, but more accurate estimates.  These estimates have historically been used to keep your patient accountable for payment; they will now also be used to keep providers accountable to estimating in “good faith”.  The No Surprises Act will require you to up your game.  You will want to implement a top-notch verification process, communication process, and collection policy.

MTB will be learning more about the specifics of the No Surprises Act in the weeks to come and if/how it affects you. We will continue to share updates and additional information with you as we learn more.

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