The implementation of the No Surprises Act on January 1st, 2022, is most likely to bring extreme opportunities and difficulties to Providers as well as Payers alike. Service providers will need to adopt brand-new payment practices to satisfy government laws, including standards for rejections and also arbitration. Payers, including Blues Affiliates, will certainly require to prepare for Price Transparency as well as counter-arbitration events. The new regulation that provides consumer protections for the member on equilibrium costs occasions will also require a brand-new partnership among payers and companies that have historically relied upon out-of-network billing.
Tina Azar, Vice President and market leader from EXL Health, as she provided insights on why acute awareness and also audio execution methods will certainly be crucial, as well as safety nets around offenses. She will discuss why as well as exactly how Blues Affiliates will certainly require to consider their functional preparedness for the law, consumer outreach efforts, and settlement approaches, consisting of:
Establishing an audio readiness prepare for Blues Affiliates
Plan strategy to make sure compliance with the costs’s guidelines
Just how to protect against prospective disagreements with service providers, arbitration submissions, and also possible non-compliance penalties