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The No Surprises Act

Means No Surprises for the Patient OR the Payer

HHC Can Help:

  • Determine the Qualified Payment Amount
  • Negotiate on Your Behalf
  • Guide Arbitration Planning

On January 1, 2022, The No Surprise Act Goes Into Effect. How Will It Affect You?

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.

Surprise Billing Can Get Complicated. HHC Can Help.

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.
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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

25+ Years of Expertise = HHC Solutions That Work

H.H.C. Group is uniquely well qualified to provide this service given its:
  • 25+ years of experience successfully negotiating settlements on medical bills on behalf of payers nationally;
  • Highly experienced, attorney, licensed health insurance adjustor negotiators;
  • Proprietary database and access to multiple published databases;
  • Panel of Board Certified Physicians and other healthcare professionals to determine whether treatments are medically necessary, medically appropriate, or otherwise qualify or do not qualify for payment. HHC Group is a URAC Independent Review Organization for Internal and External Review.

We'll get the job done for you!

CONTACT US FOR A CONSULTATION

NO SURPRISE ACT RESOURCES

young woman dealing with surprise medical bills
HEALTH INSURANCE PAYERS AND BENEFICIARIES GET CLARIFICATION ON SURPRISE BILLING

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.

no surprises act bill
NO SURPRISES ACT KEY FACTS

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.