No surprise act

docx

School

Grand Canyon University *

*We aren’t endorsed by this school

Course

205

Subject

Medicine

Date

Dec 6, 2023

Type

docx

Pages

2

Uploaded by cmooredortch

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The No Surprises Act One of the most recent healthcare legislative policies is the No Surprises Act . This act was signed into law as part of the Consolidated Appropriations Act, 2021, and took effect on January 1, 2022. The Act aims to protect patients from unexpected medical bills, particularly those incurred from out- of-network services. Impact on the Medical Profession The No Surprises Act will have several direct impacts on the medical profession: Transparency : Medical professionals will need to provide clear, upfront cost estimates to patients for services. This will require changes in billing and communication practices. Billing Practices : The Act limits the amount that healthcare providers can bill for out-of-network services to the patient's in-network cost-sharing amount. This may affect revenue for providers who often serve out-of- network patients. Dispute Resolution : The Act establishes a dispute resolution process for providers and insurers. This could lead to additional administrative work for medical professionals. Impact on My Field of Interest: Health Administration As a health administrator, the No Surprises Act will have specific impacts on my field: Policy Implementation : Health administrators will be responsible for implementing the new policies and procedures required by the Act. This includes changes to billing practices and patient communication. Training : Administrators will need to train staff on the new policies and ensure compliance. Financial Management : The Act could impact the financial management of healthcare organizations, particularly those that often serve out-of-network patients. Administrators will need to monitor and manage these impacts. For more information on the No Surprises Act, you can visit the official website . Impact Medical Profession Health Administration Transparency Changes in billing and communication practices Implementing new policies and procedures Billing Practices May affect revenue Changes to financial management Dispute Resolution Additional administrative work Training staff and ensuring compliance
No Surprise Act The No Surprise Act is a federal law in the United States that was enacted to protect patients from unexpected medical bills, particularly those incurred from out-of-network services. The Act was signed into law on December 27, 2020, as part of the Consolidated Appropriations Act, 2021. ### Key Provisions The No Surprise Act includes several key provisions: * **Protection against balance billing **: Patients are protected from balance billing for emergency services, air ambulance services provided by out-of-network providers, and certain non- emergency services provided by out-of-network providers at in-network facilities. * **Transparency in cost-sharing**: Health care providers and facilities are required to provide patients with a clear, advance notice of their network status and an estimate of charges before providing non-emergency services. * **Dispute resolution**: The Act establishes a process for resolving payment disputes between providers and insurers, known as Independent Dispute Resolution (IDR). ### Impact on Patients The No Surprise Act aims to: * Protect patients from unexpected, high medical bills. * Increase transparency in health care costs. * Improve the fairness of payment disputes between providers and insurers. For more detailed information, you can refer to the [official text of the No Surprise Act] (https://www.congress.gov/bill/116th-congress/house-bill/3630/text). > Note: The No Surprise Act applies to health care providers and health insurance plans in the United States. It does not apply to other countries.
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