No Surprises Act

Overview:

With the intent to empower patients and increase competition, the Price Transparency requirements went into effect on January 1, 2021. One year later, the No Surprises Act (NSA) added more regulations to protect patients. Simply put, the NSA protects patients from surprise medical bills that come from unknowingly receiving care from out-of-network care providers and emergency services. It also took Price Transparency to a new level by requiring providers to present a good faith estimate to uninsured or self-pay patients since January 2022 and soon issuing estimates to health plans which will use the estimate to provide an advanced Explanation of Benefits to their enrollees. Many providers still have unanswered questions about how Price Transparency and NSA affect their practice—and the steps they must take to comply with them. This presentation will attempt to answer many of those questions as we discuss how Price Transparency and NSA have evolved and where they are projected to go.

Objectives: 

• Learn which healthcare facilities/providers must comply with Price Transparency and NSA regulations
• Outline the requirements of Price Transparency
• Discuss required NSA documents and timeframes for presenting these to patients
• Explore the NSA provisions that will be enforced later in 2023 after final rulemaking

CE’s: certificate of completion

Presenter: Barbara Johnson, BSN, RN, Senior Revenue Consultant, ParaRev

As a registered nurse Barbara primarily worked in emergency medicine, then transitioned into nursing administration. She entered the specialty of Revenue Integrity as a nurse auditor where she expanded her knowledge of coding and revenue cycle compliance through membership in AAPC and HFMA. In her current position with ParaRev, she has become a subject matter expert on Price Transparency and No Surprises Act.

Registration:

Registration is free for SDAHO Members and $49 for Non-Members.

Click here to register.