Effective Jan. 1, 2022, facilities and providers must adhere to several new policies required by the No Surprises Act. Specifically, facilities and providers will not be permitted to balance bill patients in certain out-of-network scenarios unless certain conditions are met, they must provide uninsured and self-pay patients with good faith estimates for most scheduled services (or upon request), and they must provide patients with disclosures of their new rights.
The Centers for Medicare & Medicaid Services (CMS) recently released several new resources to assist with implementation. Documents include:
- a series of Frequently Asked Questions related to the federal independent dispute resolution (IDR) process and notice of consent requirements;
- a series of Frequently Asked Questions related to the uninsured and self-pay good faith estimates;
- several new guidance documents on the patient-provider dispute resolution process for providers, facilities, select dispute resolution entities, and uninsured/self-pay patients.
The AHA has been sharing resources and tools to assist members with the No Surprises Act implementation, and they are available on AHA’s surprise billing webpage. The resources include a detailed implementation guide, as well as a checklist of the policies that went into effect on Jan. 1 and a review of the new disclosure, notice and consent requirements.
In addition, the AHA and the Healthcare Financial Management Association hosts biweekly “office hours” on implementation of the uninsured and self-pay good faith estimates. Register here to participate every other Thursday, from 3-4 p.m. ET. The next call will be on January 13.
