Healthcare Finance News December 2, 2022
“Horrible policy failure” over disputed claims backlogs is added to mandates requiring an advanced hospital infrastructure.
The No Surprises Act has reportedly done its job in preventing an estimated 9 million surprise medical bills since going into effect at the start of this year, but for providers, the law has created a revenue cycle and regulatory quagmire.
Payment rates for out-of-network claims favor the insurer; the burden is on hospitals to determine whether patients are being billed correctly, and good faith estimates to patients need a system-to-system infrastructure that’s just not there.
The law and subsequent rule put in place to prevent patients from receiving a surprise medical bill, or a charge for balance billing, has created a claims processing...
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