The No Surprises Act (NSA) will impact us all–either as a patient receiving care, a provider caring for a patient, or a payer covering the cost of care. With new consumer protections enforced, provider information changes are expected to start to roll in by the thousands. Now, there’s more pressure on regional payers to keep their provider data management up to date.
In this installment of the Madaket Minute, we discuss two important numbers—48 and 30—and how they affect regional payers in regards to the NSA.
Read the video transcript below and subscribe to Madaket Health on YouTube.
Hello everyone and welcome to another installment of the Madaket Minute. In this minute we’re going to discuss a couple of numbers associated with the massive No Surprises Act. This act is going to impact every one of us in the United States because all of us either receive care or know someone that is dispensing care.
If you are a regional payer, you should be paying attention. There are two numbers that we’re going to discuss in this Madaket Minute that are of particular importance. The first one is 48. If you are a payer and a provider sends you a change of their information, you now have 48 hours to update your directory with that information. Not four to eight weeks. Not four to eight months. 48 hours.
The other number I want you to pay attention to is 30. Because if there is a non-participating provider rendering services at a participating facility and they disagree with what you’re reimbursing, you will have 30 days to resolve that. If you don’t resolve it in 30 days, it goes to an IDR, an Independent Dispute Resolution process, to which you will have four days.
Most regional payers don’t have the bandwidth to be able to do this. Updates are going to be coming in by the thousands. You need to get a handle on your provider data management.
Stay tuned for more in the next Madaket Minute.