No surprise act
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School
Grand Canyon University *
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Course
205
Subject
Medicine
Date
Dec 6, 2023
Type
docx
Pages
2
Uploaded by cmooredortch
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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