Revenue cycles challenged by mandates of No Surprises Act

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.

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