No Surprises Act Complaints
A Becker’s article discusses a report released by CMS on August 20, which outlines complaints related to the No Surprises Act and ACA compliance. In total, 16,073 complaints were filed, with over 12,000 concerning the No Surprises Act. Most complaints were against providers, facilities, and air ambulance services, with a significant portion involving surprise billing for non-emergency and emergency services, as well as issues with good-faith estimates.
For plastic surgeons, following the No Surprises Act is crucial to avoid complaints and potential penalties. By providing accurate good faith estimates, you can prevent issues with surprise billing and ensure you are transparent with your patients about costs. This not only helps in complying with the law but also builds trust with patients, reducing the likelihood of disputes.
The No Surprises Act generally applies to situations where patients receive care from out-of-network providers at in-network facilities, or in emergencies where they don’t have a choice of their provider. However, if a plastic surgeon does not take insurance or is providing cash-pay services, the specific provisions of the No Surprises Act related to surprise billing may not apply in the same way.
For cash-pay services or for plastic surgeons who do not accept insurance, one of the key requirements under the No Surprises Act is still relevant: providing a good faith estimate of expected charges. This is meant to ensure that patients are fully informed about the costs upfront, even if insurance is not involved.
So while the surprise billing protections may not apply directly, the good faith estimate requirement is still important for these situations to ensure transparency and compliance with the Act. This helps in avoiding disputes and maintaining trust with patients.
Be sure to talk to your billing company or a plastic surgery consultant with experience in plastic surgery billing.