{"id":720,"date":"2022-01-14T11:15:28","date_gmt":"2022-01-14T15:15:28","guid":{"rendered":"http:\/\/eclipsepracticemanagementsoftware.com\/blog\/?p=720"},"modified":"2022-01-14T11:15:28","modified_gmt":"2022-01-14T15:15:28","slug":"your-practice-the-no-surprises-act","status":"publish","type":"post","link":"http:\/\/eclipsepracticemanagementsoftware.com\/blog\/2022\/01\/14\/your-practice-the-no-surprises-act\/","title":{"rendered":"Your Practice &#038; the &#8220;No Surprises&#8221; Act"},"content":{"rendered":"<p>According to an email I received yesterday:<\/p>\n<blockquote><p>&#8220;In a nutshell, The &#8220;No Surprises Act&#8221; requires that patients are notified of specific costs prior to receiving the services. This includes cash based practices.&#8221;<\/p><\/blockquote>\n<p>The email goes on to specify that you must give each &amp; every patient a good faith estimate of costs prior to care. This seems to be generating some confusion. First, let&#8217;s review which patients are specifically targeted by this legislation:<\/p>\n<ul>\n<li>The related CMS content can be found here: <a href=\"https:\/\/na01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cms.gov%2Fnosurprises&amp;data=04%7C01%7C%7C01edd619ec16443800fd08d9d6d248db%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637777020930169445%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&amp;sdata=IuCAqluwoO79gPXciq5I37y%2FzcOFwK6qcWnT%2FPDgNNs%3D&amp;reserved=0\">https:\/\/www.cms.gov\/nosurprises<\/a>.<\/li>\n<li>This legislation targets patients &#8220;<em>who get <strong>emergency care, non-emergency care from out-of-network providers at in-network facilities<\/strong><\/em>&#8221; (Hospitalized patients are the most likely recipients here!)<\/li>\n<li>Furthermore: &#8220;<em>Providers, facilities and air ambulance providers are also <strong>required to\u00a0give uninsured (or self-pay) individuals<\/strong>\u00a0good-faith estimates of expected charges for scheduled health care services.<\/em>&#8220;<\/li>\n<li>An overview with links can be found here:\u00a0<a href=\"https:\/\/na01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cms.gov%2Fnosurprises%2Fpolicies-and-resources%2Foverview-of-rules-fact-sheets&amp;data=04%7C01%7C%7C01edd619ec16443800fd08d9d6d248db%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637777020930169445%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&amp;sdata=8zQlV4O7rT7eBcq6o5olmQqHAD35Ph6ONjFtHk%2Fcqac%3D&amp;reserved=0\">https:\/\/www.cms.gov\/nosurprises\/policies-and-resources\/overview-of-rules-fact-sheets<\/a><\/li>\n<li>Guidance regarding\u00a0good faith estimates and the Patient-Provider Dispute Resolution can be found here:\u00a0<a href=\"https:\/\/na01.safelinks.protection.outlook.com\/?url=https%3A%2F%2Fwww.cms.gov%2FCCIIO%2FResources%2FRegulations-and-Guidance%2FDownloads%2FGuidance-Good-Faith-Estimate-Patient-Provider-Dispute-Resolution-Process-for-Providers-Facilities-CMS-9908-IFC.pdf&amp;data=04%7C01%7C%7C01edd619ec16443800fd08d9d6d248db%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637777020930169445%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000&amp;sdata=i3B4m3S2BxgGFzdGYkqpiyw3vUZ3Tuj%2FJKZIAXGh%2BMs%3D&amp;reserved=0\">https:\/\/www.cms.gov\/CCIIO\/Resources\/Regulations-and-Guidance\/Downloads\/Guidance-Good-Faith-Estimate-Patient-Provider-Dispute-Resolution-Process-for-Providers-Facilities-CMS-9908-IFC.pdf<\/a><\/li>\n<\/ul>\n<p>Now let&#8217;s discuss it. For most providers who generally see non-emergency patients during scheduled visits at their offices, this should simply be &#8220;business as usual.&#8221;\u00a0The legislation takes aim at unexpected emergency care\/bills relating to situations like:<\/p>\n<ul>\n<li>An out-of-network physician treating an insured patient at an in-network hospital. (There aren&#8217;t many alternate situations where this would happen in a doctor&#8217;s office.)<\/li>\n<li>Air ambulances &#8212; which can cost $40,000!!!<\/li>\n<\/ul>\n<p>The overwhelming goal is to protect consumers from catastrophic costs for unexpected bills.<\/p>\n<p>Your patients should be always be apprised of costs at the beginning of care. Most providers I know already operate this way. And it&#8217;s important that you don&#8217;t bury any disclosed fees under a mountain of other patient forms. (Yes&#8230; that&#8217;s specifically noted in the CMS documentation.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>According to an email I received yesterday: &#8220;In a nutshell, The &#8220;No Surprises Act&#8221; requires that patients are notified of specific costs prior to receiving the services. This includes cash based practices.&#8221; The email goes on to specify that you &hellip; <a href=\"http:\/\/eclipsepracticemanagementsoftware.com\/blog\/2022\/01\/14\/your-practice-the-no-surprises-act\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[12,13],"tags":[],"class_list":["post-720","post","type-post","status-publish","format-standard","hentry","category-general","category-practice-management"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Your Practice &amp; the &quot;No Surprises&quot; Act - ECLIPSE Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/eclipsepracticemanagementsoftware.com\/blog\/2022\/01\/14\/your-practice-the-no-surprises-act\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Your Practice &amp; the &quot;No Surprises&quot; Act - ECLIPSE Blog\" \/>\n<meta property=\"og:description\" content=\"According to an email I received yesterday: &#8220;In a nutshell, The &#8220;No Surprises Act&#8221; requires that patients are notified of specific costs prior to receiving the services. 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