AAPM&R National Grand Rounds: No Surprises Act: Three Things You Need to Know Now about Surprise Billing-Session Presentation

Video Transcription

Video Summary

The video transcript summarizes a presentation on surprise billing and the No Surprises Act. The presenter highlights that surprise billing is not limited to the emergency setting and ancillary services, but has broader implications for providers. The No Surprises Act applies to non-emergency care from out-of-network providers at in-network facilities, and it aims to protect patients from balance billing. There are patient disclosure requirements that providers must meet, including displaying disclosures on public websites and posting signs at their facilities. Providers are also required to provide patients with a one-page disclosure explaining their rights and protections. The presenter discusses the notice and consent provisions, which allow patients to waive their balance billing protections. Providers must provide a good faith estimate for services that patients are waiving their protections for. The presenter explains that providers are obligated to provide good faith estimates for uninsured or self-pay patients for all scheduled services. The presentation also mentions the federal independent dispute resolution process for resolving payment disputes between providers and payers. The presenter emphasizes that litigation is challenging the guidance given to arbiters in the dispute resolution process. However, this litigation does not affect the other requirements discussed in the presentation. Overall, the presentation provides an overview of the No Surprises Act and its implications for providers.

Keywords

surprise billing

No Surprises Act

providers

balance billing

patient disclosure requirements

good faith estimate

uninsured patients

dispute resolution process

litigation