If you’re a health plan, have internal health plans, or contribute provider information to a health plan, there are 4 new compliance tasks that went into effect on January 1, 2022 that you should know about.
According to the No Surprises Act, you must:
In this post, we’ll provide an overview of the No Surprises Act and its requirements. We’ll also explore how different VerityStream solutions can keep you organized, compliant, and stress-free.
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.
The act requires health insurers and healthcare providers to work together to ensure consumers are informed and protected. It also outlines a few different requirements:
The No Surprises Act was developed to protect patients from worrying about unexpected medical bills. It establishes new federal protections against most surprise out-of-network medical bills.
These new federal protections will:
The protections will also help address a variety of patient pain points, like:
While the new law provides patients with important federal protection from unexpected out-of-network medical bills, its associated regulations and provisions can be a heavy task for health plans as they require outreach to providers for attestations every 90 days to confirm directory accuracy. If you’re concerned about meeting these new requirements, we have great news for you! VerityStream has easy-to-use tools to support your organization's compliance with the No Surprises Act.
To ensure you remain compliant, there are three main focus areas that the VerityStream suite of services can help you with: accurate data gathering, provider information verification, and reporting capabilities. These capabilities are available through all of our solutions including our legacy solutions, EchoCredentialing, EchoOneApp, and MSOW.
If you are a current client, we recommend you reach out to your account representative for more precise details on how your current solution can support your organization’s compliance needs. Here is an outline of each area of focus.
For those who have adopted (or are preparing to adopt) CredentialStream, our complete provider lifecycle solution, you will find that it will help with the No Surprises Act in four main ways:
In addition to those capabilities, CredentialStream’s newest offering, Network, brings together the full provider lifecycle within a health plan, including credentialing, recredentialing, and provider data management activities. In support of the No Surprises Act, Network will assist in improving directory accuracy.
With Network, users can:
With the right tools in hand, we’re certain the No Surprises Act won’t be able to catch any one of you off guard. As always, VerityStream is here to help. If you have any questions about how our suite of tools can help, give us a call. For access to the full webinar outlining in-depth information on how all of our solutions can be utilized, watch a recording here.