It’s only been a year since the No Surprises Act went into effect, and already it has prevented over 9,000,000 surprise medical bills. These millions of Americans can breathe a little easier now they know someone has their back. But, they’re not the only ones in this messy equation. Labs and providers need support, too, and careviso is here to help.
This law also impacts clinical labs and pathology services. It is estimated that about 10-20% of all pathology and laboratory services may be out of network, and therefore may fall within the jurisdiction of the No Surprises Act. Included in this new law is a process for billing disputes. The health plan or medical facility can ask for arbitration by an independent third-party for disputed medical bills. The Centers for Medicare and Medicaid Services (CMS) has a list of certified Independent Dispute Resolution Entities.
Good Faith Estimates
GFEs must include expected charges for:
The healthcare system in the United States is complex and fragmented. The No Surprises Act and Hospital Price Transparency rule are meant to protect patients from unnecessary high costs of critical medical care. The goal of healthcare is to provide the right treatment at the right time for the right patient. Patients should not be responsible for unreasonable medical costs just because they unknowingly use a provider who is out of network. Hopefully, the No Surprises Act and Hospital Price Transparency rule will financially protect all patients who need medical care.
careviso is a healthcare technology company supporting everyone involved in diagnostic testing. We created a proprietary platform, seeQer, for payors, physicians, and laboratories that improves patient care through streamlined workflows. By automating the impossible we’re solving the most complex problems in the healthcare industry: prior authorizations and financial transparency. Sign up for a demo of seeQer and learn more here.