tci Medicare Compliance & Reimbursement - 2022 Issue Q2

No Surprises Act: Feds Modify NSA Guidance Post-Lawsuit

Plus: CMS releases two new FAQs. The feds continue to tweak their balance billing referendum, the No Surprises Act, offering new guidance after legal battles reshape the regulation. Read on for the latest updates. Definition: Balance billing, also known as surprise billing, generally occurs when a patient receives care expecting an in-network rate or by in-network clinicians, but the facility or doctor is actually out of network. The provider then bills the patient directly, leading to a bill higher than the patient anticipated due to the misunderstanding about in-network status. Though this most frequently happens in emergencies, receiving care...

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