The goal of the No Surprises Act is to protect patients from receiving bills from out-of-network providers that they did not willingly choose. This means out-of-network providers will be restrained in their ability to balance bill, and will be paid even lower rates by payors. While the law has good intentions, it is skewed in favor of the payors, and the providers are left to scramble. Groups that previously depended on out-of-network billing will have to adapt to this new competitive reality.
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Collect Rx has been helping out-of-network providers negotiate with third party vendors since 2006. The No Surprises Act does not change anything about our Upfront Recovery service except that the potential volume may increase. The payors are planning for an increase in upfront settlement requests, but are not ready to take on the volume of potential disputes from providers, so they have hired third party vendors to take on this task. Collect Rx is uniquely positioned to take on all volumes of settlement request from all commercial payors.
Today, Collect Rx deploys a service for out-of-network providers to identify underpaid claims and settle them for additional dollars. We take on this task for Aetna, Cigna, and United Healthcare commercial plans. Over time, with the NSA in place, we will look to broaden the commercial plans we can address under this service line.
Schedule a brief 15-30 minute call with us to discuss your needs and concerns surrounding out-of-network claims and surprise billing. We’re here to help you navigate these changes.
Learn more about what you can do to assist your organization with these changes.
Here are 6 Provisions of the No Surprises Act:
Between balancing patients, managing staff, scheduling, evaluating A/R, and more, we know you don’t have time to also keep track of Surprise Billing changes. Let Collect Rx take this off your already busy schedule, so you can focus on your patients!