The Qualifying Payment Amount (QPA) plays a significant role in the No Surprises Act (NSA). When managing compliance with the NSA, it is essential to understand what the QPA is and how it impacts payors, providers, and members.
Alternative health plan services often raise questions, and that’s exactly why this Q&A Guide was created. Based on real conversations with brokers and employers, it offers straightforward answers that cut through confusion and help you understand how these plans work, who they’re for, and the impact they can make.
The No Surprises Act (NSA) protects patients from unexpected medical bills, but it also brings new challenges for health plans. In this blog post, we answer key questions about how the NSA works, which claims are affected, and how payors can stay compliant.
The Federal No Surprises Act (NSA) and state-level surprise billing laws share a common mission: shielding patients from unexpected medical bills. However, the mechanisms they use to achieve this goal can differ significantly. From how terms are defined to how disputes are resolved, understanding these differences is essential for compliance and effective administration.
It’s been 3 years since the No Surprises Act (NSA) went into effect and we’re sharing key insights.
The No Surprises Act and the IDR process present unique challenges for payors and providers – from an inefficient portal to a shortage of IDR entities and constantly changing rules. In this blog post, we discuss the top 8 challenges we’ve encountered and what you can do to address them.
A high-level overview of the proposed Federal IDR Operations rules under the No Surprises Act, highlighting key changes aimed at improving communication, reducing disputes, and streamlining payment determinations between payers and providers.
Medical bills are a top stressor among patients and most agree that dealing with them is highly stressful and inconvenient. In fact, 56% of patients report that generally medical bills are a leading source of stress. Figuring out these bills is also often hard, which leads to confusion on top of the anxiety about the cost itself. Therefore, balance bills can add another source of stress.
Claritev summarizes the FAQ issued by the Biden administration on October 6, 2023 as well as the reopening of the IDR portal.
On September 20, 2023, the Biden Administration released the first of two pending proposed rules related to the federal IDR process. Claritev discusses it.