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"No Surprises Act" Implementation

There is a new healthcare act effective as of January 1, 2022, titled the No Surprises Act. This Act will establish new federal protections against surprise medical bills that will take effect in 2022.


The surprise billing can occur when patients are seen from out-of-network hospitals, doctors, or other providers that aren't personally chosen. The Act comes into play when the health plans retract out-of-network claims and/or apply higher out-of-network expense sharing.


Who NSA applies to:


The Act prevents doctors and hospitals from billing patients more than the in-network cost-sharing amount for surprise bills. A $10,000 maximum penalty/violation can be charged to the providers' office per mistake.


An exception to the NSA is permitted if patients give preliminary written consent to have their rights be waived under the No Surprises Act. This affects patients by requiring private health plans to tend those out-of-network claims and add in-network cost-sharing.


Providers and doctors' administration teams struggled before January 1 with how they could become compliant. All parties involved will effectively keep up with bills with different insurance providers, nationally and locally.


Orthopaedic Associates faced challenges finding the best online system program to use and feel confident in their management of the NSA. A patient service representative can help you with questions at (812)424-9291 or the toll-free phone number for the No Surprises Help Desk: 1-800-985-3059. 


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