Author: Howard Healthcare Group

One of the single most essential factors to maximize medical out-of-network claim reimbursement is accurate medical billing and coding. Even the slightest mistake can result in a delay or denial of a claim as payor automated processing systems are set up to deny claims for billing and coding errors. A successful coding and billing process should yield a nearly 100% claim acceptance rate. Practices also need to understand how a billing department/company has established its

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In late 2020, the No Surprises Act was enacted into law. The No Surprises Act changes the landscape for out-of-network medical billing as the NSA regulates virtually every patient claim that will present to your practice- including those for self pay and the uninsured. The law, together with the first two of many rules that have followed, contain over 1,000 pages of new requirements that will require an in-depth understanding by your medical biller in

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Xavier Becerra, Secretary of the U.S. Department of Health and Human Services (HHS) recently informed the House Appropriations Committee that he would be seeking feedback from stakeholders before enacting a policy to end surprise billing although he did not affirm whether he would use the formal rulemaking process. Typically, the rulemaking process sets out proposed regulations and then welcomes comments from all stakeholders. The No Surprises Act applies to ERISA self-funded and fully insured plans and prohibits

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