HHC Group recently announced the launch of its Surprise Bill Resolution Assistance Service (SBRAS). SBRAS is designed to assist payers who will be impacted by the No Surprises Act. As of July 1, HHS released its latest guidance in an interim final rule, or IFR, titled "Requirements Related to Surprise Billing; Part I." It bans Surprise Billing for emergency services, regardless of where they are provided and bans out-of-network charges without notice for ancillary care or care by an out-of-network provider at an in-network facility in all circumstances.
In the very near future, every second will count when you receive a unexpected, out-of-network bill for payment. HHC Group can help your prepare for the future effects of the No Surprise Bill by establishing internal processes for fast assistance ahead of time. Here's how we can help during the strict timelines for processing these out-of-network expenses as soon as you get them.
First 30 Days |
Second 30 Days |
No Resolution -> Arbitration |
|
Qualifying Payment Amount (QPA) Determination | Negotiation | Negotiation | Arbitration Planning |
Is the price the provider charging appropriate for the location and market of the patient receiving the procedure? If you don't have enough claims data to make a qualified price determination, HHC Group can help. We can determine what the QPA should be for the procedure. We'll get the job done for you. |
Once the QPA is determined on a claim, HHC Group will attempt to negotiate a settlement with the provider and avoid the cost and risk of going to arbitration. We've successfully negotiated down tens of thousands of claims, saving clients hundreds of millions. We'll get the job done for you. |
If you've remitted the QPA to the provider and they have rejected or questioned payment, you can still avoid the risk of potentially expensive arbitration. How? By having HHC Group negotiate a settlement with the provider on your behalf. We've successfully negotiated tens of thousands of claims, saving clients hundreds of millions. We'll get the job done for you. |
The person who makes the best case wins. HHC Group can assist you in determining an amount to offer that is appropriate, logical and defensible and provide the analysis to support the proposal? As leaders in the industry with over 25 years of historical data, we have been continuing to satisfy clients with you our expertise. We'll get the job done for you. |
LEARN MORE | LEARN MORE | LEARN MORE | LEARN MORE |
First 30 Days | |
Qualifying Payment Amount (QPA) Determination | |
Is the price the provider charging appropriate for the location and market of the patient receiving the procedure? If you don't have enough claims data to make a qualified price determination, HHC Group can help. We can determine what the QPA should be for the procedure. We'll get the job done for you. | |
Negotiation | |
Once the QPA is determined on a claim, HHC Group will attempt to negotiate a settlement with the provider and avoid the cost and risk of going to arbitration. We've successfully negotiated down tens of thousands of claims, saving clients hundreds of millions. We'll get the job done for you. | |
LEARN MORE | |
Second 30 Days | |
Negotiation | |
If you've remitted the QPA to the provider and they have rejected or questioned payment, you can still avoid the risk of potentially expensive arbitration. How? By having HHC Group negotiate a settlement with the provider on your behalf. We've successfully negotiated tens of thousands of claims, saving clients hundreds of millions. We'll get the job done for you. | |
LEARN MORE | |
No Resolution -> Arbitration | |
Arbitration Planning | |
The person who makes the best case wins. HHC Group can assist you in determining an amount to offer that is appropriate, logical and defensible and provide the analysis to support the proposal? As leaders in the industry with over 25 years of historical data, we have been continuing to satisfy clients with you our expertise. We'll get the job done for you. | |
LEARN MORE |
Health Insurance Payers Ask: How Should I React to the No Surprises Act and the Latest Surprise Billing Rule? That's a great question and we'll attempt to provide some definitive answers. I think we would all agree that there are still some surprises left in the No Surprises Act.
Congress passed the No Surprises Act ("Act") as part of the recent stimulus bill and it was signed into law on December 28. The major provisions of the Act go into effect January 1, 2022.