Deconstructing the No Surprise Billing Act (NSBA)

The No Surprise Billing Act (NSBA) was created to protect consumers from receiving surprise medical bills from out-of-network providers at in-network facilities.  The No Surprise Billing Act has completely transformed the managed care health insurance payer contracting landscape resulting in a dramatic shift in payer behavior.  Many health insurers are now forcing more providers into out-of-network status in an effort to reduce their payments through the host of consumer protections created in the NSBA.  More out-of-network providers results in more out-of-network payment disputes, which allows the insurer to get out of paying providers in a timely manner and ties up provider time and increases administrative costs and burden to collect reimbursement.  There have been many recent legal challenges in 2023 that have further complicated the NSBA requirements.

The NSBA applies to not only people covered under group and individual health insurance plans, but also protects uninsured and self-pay patients. The NSBA rule requires a whole new host of compliance considerations for healthcare organizations to work through to ensure compliance with federal law.  These new requirements include providing good faith estimates to patients prior to receiving services, ensuring fees are reasonable and customary within the respective medical market, and participating in payment disputes via the new independent dispute resolution (IDR) process. This webinar will drill down into the NSBA provisions extensively, discuss the role of good faith estimates, explain the IDR process, discuss recent legal challenges, and provide you with tangible information that can be put into action immediately.

Webinar Objectives

The No Surprise Billing Act (NSBA) was enacted as a consumer protection measure in response to unprecedented rates of surprise medical bills. This session will discuss the key NSBA provisions, discuss the good faith estimate requirements, explain the IDR process and common challenges, and provide tips for complying with the NSBA.

Webinar Agenda

• Understand the consequences of balance billing and surprise billing as it pertains to the NSBA
• Recognize the key consumer protection provisions of the NSBA
• Understand who the NSBA applies to
• Recognize the requirements of Good Faith Estimates
• Understand the IDR process and what tools you have as a healthcare organization
• Understand recent legal challenges to the NSBA
• Recognize next steps your organization should take to comply with the NSBA

Webinar Highlights

• Discuss the concept of balance billing
• Identify key NSBA provisions that affect medical practices of all sizes and specialties
• Review who the NSBA applies to specifically
• Discuss consumer protections covered under the NSBA
• Review how the NSBA affects providers, facilities, and air ambulance providers
• Explain how care settings impact application of the NSBA
• Discuss the role of Good Faith Estimates
• Unpack the independent dispute resolution (IDR) process
• Discuss recent legal challenges to the NSBA
• Discuss strategies for educating key stakeholders on complying with the NSBA
• Identify next steps for your organization to successfully comply with the NSBA

Who Should Attend

Professional Fee Coders, Auditors, Billers, Educators, Consultants, Revenue Cycle Management Professionals, Coding Management and Operational Leadership, Behavioral Health Providers, Mental Health Providers, Psychiatrists, Psychologists, Clinical Social Workers, Physician Advisers, Compliance Officers/Committees