How the No Surprises Act Changes Reimbursement
The No Surprises Act (NSA), effective January 1, 2022, changes the reimbursement process for claims identified as surprise bills. Claritev explains how.
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What Plans and Services Are Impacted by the No Surprises Act
As 2022 rings in, so does the No Surprises Act (NSA). While the healthcare industry has been preparing for the NSA for over a year, there may still be some confusion over what types of plans are impacted by the new law as well as what types of services.
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MultiPlan’s End-to-End Surprise Billing Service Gaining Traction
MultiPlan’s Surprise Billing Service helps payors manage the full lifecycle of surprise bills while supporting compliance with the No Surprises Act.
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No Surprises Act and Its Impact on Self-Funded Plans
This interview explores the impact of the No Surprises Act on reference-based pricing and self-funded health plans.
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Reference-Based Pricing Is Here to Stay
Claritev explores why the No Surprises Act will have minimal impact on reference-based pricing.
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MultiPlan Appoints Industry Veteran to Lead Surprise Bill Arbitration Services
MultiPlan appointed industry veteran Liz Longo to lead its surprise bill arbitration services, strengthening its end-to-end approach to help healthcare payors comply with No Surprises Act regulations.
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September 30th Interim Final Rule Brings Clarity to the Arbitration Process
The 2nd Interim Final Rule for the No Surprises Act clarifies the arbitration process and the importance of the QPA.
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Post Pay Negotiation and Baseball-Style Arbitration Replace Balance Billing for Surprise Bills
“Baseball-style” arbitration under the No Surprises Act is designed to encourage payors and providers to reach agreement before formal dispute resolution. By requiring arbitrators to choose between final payment offers rather than splitting the difference, the process incentivizes both sides to submit reasonable proposals and settle disputes more efficiently without prolonged arbitration.
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Value-Driven Health Plans Take Reference-Based Pricing to the Next Level: A Q&A with Ryan Day, President of HST
In November of 2020, Claritev acquired HST. We sat down with HST’s president, Ryan Day, to learn about HST’s past and plans for the future.
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What Is QPA?
The Qualifying Payment Amount (QPA) is a central component of the No Surprises Act, representing the median in-network rate used by health plans to determine out-of-network reimbursement. Understanding how QPA is calculated and applied is critical for payors and providers navigating payment decisions and the IDR arbitration process.