Surprise Billing

No Surprises Act Prevented 10M Surprise Medical Bills, But IDR Use Grows

January 30, 2024 - The No Surprises Act (NSA) helped prevent 10.1 million surprise medical bills in the first nine months of 2023, according to a survey from AHIP and the Blue Cross Blue Shield Association (BCBSA). The No Surprises Act took effect on January 1, 2022, for those enrolled in commercial health insurance or group health plans. The law states that when...

Read More


More Articles

Payers, Employers Support the No Surprises Act IDR Process in Court

by Victoria Bailey

The provisions of the No Surprises Act rule that detail the independent dispute resolution (IDR) process for out-of-network claims have been making waves in the healthcare space. The No Surprises Act...

Experts Assess the Effects of the No Surprises Act on Surprise Billing

by Kelsey Waddill

The No Surprises Act may have successfully defended consumers from surprise billing but requires reworking in other areas, an issue brief from Urban Institute and the Robert Wood Johnson Foundation...

How Payer, Provider Alignment Enables Simplified Medical Billing Format

by Kelsey Waddill

When Banner|Aetna conducted market research and asked their members to name the primary barrier that prevented them from engaging easily with healthcare, the payer’s leadership did not expect the answer to involve medical...

No Surprises Act Leads to 9M Averted Surprise Bills, 275K Arbitration Claims

by Kelsey Waddill

The No Surprises Act effectively averted surprise bills for 9 million Americans in the first nine months of 2022, but the federal independent dispute resolution process is overwhelmed, according to a...

Consumers Continue to Experience Surprise Billing After No Surprises Act

by Kelsey Waddill

Although the No Surprises Act went into effect at the beginning of 2022 to protect consumers from receiving unexpected healthcare bills, consumers have reported that they continue to be affected by...

No Surprises Act May Have Blocked 2M Surprise Billing Claims

by Kelsey Waddill

Since the No Surprises Act went into effect, the law has prevented more than two million surprise billing claims in its first two months of enactment, according to a survey from AHIP and the Blue Cross...

How The No Surprises Act Seeks to Change Surprise Billing

by Kelsey Waddill

The No Surprises Act used a couple of methods to reduce surprise billing, though the need for some modifications may remain, according to a resource from AHIP. “The real problem of surprise...

Oscar Health Cost Estimator Tool Aims to Increase Price Transparency

by Victoria Bailey

Oscar Health has launched an updated cost estimator tool to increase price transparency around healthcare costs and help members plan for their medical bills in advance. “Since day one, Oscar...

AHIP, BCBSA Back HHS, Interim Final Rule in Surprise Billing Lawsuit

by Victoria Bailey

AHIP and the Blue Cross Blue Shield Association (BCBSA) have filed amicus briefs that support the Department of Health and Human Services (HHS) in the surprise billing lawsuit raised by the Texas...

Payer, Provider Collaboration May Improve Provider Directories

by Victoria Bailey

Health plan provider directories can be a helpful resource for patients, but they are not always accurate. A shared effort from health plans and providers that includes streamlining data collection and...

ACHP: Extend Transparency, Interoperability Compliance Deadlines

by Victoria Bailey

The Alliance of Community Health Plans (ACHP) has asked CMS to reassess surprise billing, cost transparency, and interoperability compliance deadlines and health data exchange policies that are putting...

HHS Addresses Surprise Billing in Commercial Health Plans

by Kelsey Waddill

The Biden administration has issued an interim rule that regulates surprise billing in commercial health plans and employer-sponsored health plans, CMS announced. “No patient should forgo care...

51% Emergency Ground Ambulance Rides Result in Surprise Billing

by Kelsey Waddill

Ground ambulance rides, which were excluded from the No Surprises Act, continue to contribute to surprise billing in the US, a Peterson-Kaiser Family Foundation brief found. Experts analyzed 2018...

BCBSOK, OUHP Settle Dispute, Work Toward Long-Term Contract

by Victoria Bailey

After months of negotiations, Blue Cross and Blue Shield of Oklahoma (BCBSOK) and OU Health Physicians (OUHP) settled their dispute and have agreed upon a contract that will keep the provider...

Downstream Impacts of Recent Surprise Billing Law Remain Uncertain

by Kelsey Waddill

The impacts related to the No Surprises Act—which Congress included in the Consolidated Appropriations Act in order to address surprise billing—remain unclear, a Kaiser Family Foundation...

How Payers Can Make Medical Billing More Streamlined, Transparent

by Kelsey Waddill

Medical billing is notoriously complicated and taxing for members and providers alike. But payers have the ability—and, some might argue, the responsibility—to clarify and simplify the...

Surprise Billing Law Covers Contract Disputes, Price Transparency

by Kelsey Waddill

Congress has passed a new law that seeks to eliminate surprise billing, particularly surprise bills that result from contract disputes, inaccurate provider directories, and air ambulatory...

Cancer Patients Paid $5.6B Out-of-Pocket Cancer Costs in 2018

by Kelsey Waddill

Cancer patients are paying higher and higher out-of-pocket costs for treatment and, according to the American Cancer Society’s recent report, payer-related costs are the most common contributor...

Surprise Billing Policies May Decrease Commercial Payer Premiums

by Kelsey Waddill

For three major payers, surprise billing policies had an impact on premiums, a study published in the American Journal of Managed Care found. The researchers used data from the Health Care Cost...

Recent Articles