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What health care businesses must know about the No Surprises Act

On Behalf of | Feb 17, 2022 | Firm News, Healthcare Business

For health care businesses in Texas as well as other states, the new No Surprises Act promises to make big changes to how billing works. It is a ban on charging patients out of network charges in emergency care, during air transports, or when they are at a facility that is in their network.

No Surprises Impact

Previously, patients could experience surprise bills when they went into a procedure, especially an emergency procedure, only to find that one of the care providers was not in-network. This meant that they would be charged the out-of-network rate for that service, which could be a massive bill. The new law means that in the emergency room and the other listed situations, patients will only pay their in-network rate. If a doctor who is out of network was involved, they will have to work out the reimbursements with the insurance company or be content with that in-network rate.

As a health care business, this provides new challenges and issues to manage. Billing is more complex than ever before. The provision in the No Surprises bill where the insurer and provider work out the money requires that the deal be settled in 30 days, so this is a short period of time to work out a tricky transaction. This law changes a lot about how billing will work for emergencies as well as affiliated facilities.

The objective of this law is to protect patients from unexpected out-of-network bills. Its impact on businesses will be more complex and it will take more time to adapt to this changed environment.