The No Surprises Act has partially become effective following a chaotic and incomplete implementation process. During this webinar, healthcare attorney, Thomas J. Force, Esq. will discuss and breakdown what you need to know regarding:
In particular, through this program, you will learn, in detail, what is required to satisfy the aforementioned requirements. As such, you will be educated as to the form, content, and mediums for the various disclosures. Furthermore, you will be informed about the protocols for properly issuing notice and securing a patient’s consent to allow for balancing billing (i.e., over and above the patient’s in-network cost-share). Finally, advice as to the timing, form, and required information for the provision of a good faith estimate to an uninsured/self-pay patient will be shared, bearing in mind that such a good faith estimate serves as the basis for determining whether a patient can initiate a patient-provider dispute to be decided via arbitration.
In addition, during this webinar, Mr. Force will update you on the status of the cases brought by the American Medical Association and American Hospital Association, as well as by the Texas Medical Association, among others, against the U.S. Departments of Health and Human Services, Labor, and the Treasury. These lawsuits generally centre around the current version of the regulations regarding calculation of the out-of-network reimbursement rate and undue pressure being put on in-network providers to accept reduced rates of reimbursement. These legal cases will be pivotal in determining the effect that the No Surprises Act will ultimately have, as the issue being decided is of critical important in determining how out-of-network reimbursement is calculated (i.e., either similar to in-network rates or based on fair and reasonable considerations).
At the conclusion of this program, there will be an opportunity to have your questions answered by Mr. Force, helping to guaranty that you get substantial value from virtually attending this program.
This presentation seeks to provide clarity to a law that has been haphazardly implemented, despite the multitude of requirements it imposes. Despite the uncertainty underlying the implementation of the No Surprises Act, practices, providers, and facilities remain obligated to comply with numerous aspects thereof.
In addition, this presentation seeks to flesh out the logistics of the notice and consent process and the provision of the good faith estimates to uninsured/self-pay patients, as failure to satisfy the requirements of such processed can have significant negative consequences (i.e., difficulty, if not impossibility, of defending patient-provider disputes; inability to balance bill the patient; etc.).
Healthcare providers and facilities, especially out-of-network providers.
As a state and federally licensed attorney in both New Jersey and New York, Mr. Force has over 30 years of experience in the healthcare and insurance industries. His success as a Wall Street insurance litigator and his tenure as General Counsel for a New York-based Accident and Health Insurance Company where he served as Chief Compliance Officer propelled the founding of The Patriot Group. The Patriot Group is a full service revenue recovery company that provides billing, collections, and follow-up services as well as assistance with managed care appeals, managed care contracting, credentialing and compliance.
Mr. Force is nationally recognized as an expert in revenue collection techniques, managed care contracting and appeal strategies. Mr. Force remains an active member and frequent speaker on managed care and collection techniques for the Health Finance Management Association, the Suffolk County Bar Association, and other organizations. A United States Marine, Mr. Force received the prestigious Meritorious Mast Award for Leadership in 1987. Mr. Force is also co-Chairman of the Health and Hospital Committee of the Suffolk County Bar Association. He is co-founder of the Healthcare Reimbursement Attorneys Network, a national association of attorneys that represent physicians and hospital clients. Mr. Force also works closely with the American Medical Association and various state Medical Associations.
Recorded Webinar -
Lessons Learned from the Cigna and Aetna Cases Against Humble Surgical Hospital
Recorded Webinar -
How to Defend Against Insurance Company Recoupments, Repayment Demands, and SIU Audits