The No Surprises and Surprise Billing Consumer Protections Acts-GHAPYANoSurprisesWebinarRecording

Video Transcription

Video Summary

The Georgia Hospital Association hosted a webinar to discuss the implications of the No Surprises Act and Surprise Billing Consumer Acts. Lindsay Kaysen opened the session, ensuring participants had access to necessary technical tools for engagement. The presentation primarily featured Kathy Reap, who provided an extensive overview of surprise billing and the requirement for good faith estimates.<br /><br />Surprise billing, or balance billing prohibitions, applies to both emergency and non-emergency services offered by in-network facilities and providers. These regulations are not applicable to physician office services but do include hospital, critical access hospital, free-standing emergency departments, ambulatory surgical centers, and air ambulances. The act is applicable to various insurance plans, excluding Medicare, Medicaid, and health sharing ministries. A pivotal component includes a necessary provider notice on rights under the billing acts, with state-specific adaptations applicable to local regulations like those in Georgia.<br /><br />Kathy outlined scenarios for billing including emergency services and non-emergency instances where in-network facilities must adhere to specific billing practices or secure patient consent to balance bill. For disputes regarding billing amounts, a federal independent dispute resolution process is in place, emphasizing the qualifying payment amount as the starting point for negotiations, although this is under legal scrutiny.<br /><br />Donna Hatcher addressed the Georgia-specific context and dispute resolution criteria, highlighting local variations. Providers are expected to maintain detailed records and provide good faith estimates for uninsured and self-pay patients, emphasizing accuracy and timeliness, as the penalties for discrepancies and non-compliance may be severe.<br /><br />Kathy concluded with a checklist and roadmap for providers to ensure compliance while addressing participant questions. The session underscored the complexities of implementing new billing reforms amidst existing operational challenges in healthcare facilities.

Keywords

Georgia Hospital Association

No Surprises Act

Surprise Billing Consumer Acts

webinar

surprise billing

balance billing

good faith estimates

emergency services

independent dispute resolution

insurance plans

provider compliance

billing reforms

healthcare facilities