ICD10monitor November 8, 2023
What happens when the streams cross?
One of the most memorable lines from the 1984 comedy film Ghostbusters was when Harold Ramis’s character, Egon Spengler, warns ominously of the team’s proton pack weapons: “Don’t cross the streams!” My colleagues and I have written many articles about hospital price transparency, and many more about the No Surprises Act (NSA). But what happens when those two streams cross? That’s a topic we haven’t discussed – until now.
One element of the NSA is that when a healthcare organization believes it is being under-compensated by an insurance company, there is an independent dispute resolution (IDR) process to determine whether the qualified payment amount (QPA) offered by the insurance company is fair....
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