As its name implies, the No Surprises Act, effective January 1, 2022, is designed to protect patients from receiving surprise medical bills, particularly out-of-care network costs. While aiming for transparency, the new law will necessitate health and mental health professionals to adjust their claims processing, notice procedures, and administration processes. According to a recent National Law Review article, “[B]ills are often a surprise because the patient either was not able to choose whether to use an in-network or out-of-network facility or provider, or was not aware that the provider was out-of-network until after the services were rendered.” Emergency services must be provided, whether in- or out-of- network, unless there are established exclusions or coordination of benefits.

Good Faith Estimate