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The No Surprises Act

Means No Surprises for the Patient OR the Payer

HHC Can Help:

  • Negotiate on Your Behalf
  • Independent Reviews for Qualification Determination

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

Surprise Bill Resolution Assistance Service (SBRAS) is designed to assist payers who are being impacted by the No Surprises Act. The Act 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.

Every second counts when you receive an unexpected, out-of-network bill for payment. HHC Group can help you prepare for the effects of the No Surprise Act by establishing internal processes for fast assistance ahead of time. Here's how we can help you achieve appropriate settlements within the strict timelines for processing these surprise out-of-network claims as soon as you get them.

First 30 Days

Open Negotiation
Second 30 Days

IDRE Arbitration Period

Negotiation Negotiation Negotiation
Even before 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 during the 30-business day Open Negotiation Period. We'll get the job done for you.
Even after the 30-day Open Negotiation period and the filing by one of the parties to enter into the Independent Dispute Resolution process, we will keep negotiating to get a favorable settlement for you.
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First 30 Days

Negotation
Even before 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

Open Negotiation
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 during the 30-business day Open Negotiation Period. We'll get the job done for you.
LEARN MORE

IDRE Arbitration Period

Negotation
Even after the 30-day Open Negotiation period and the filing by one of the parties to enter into the Independent Dispute Resolution process, we will keep negotiating to get a favorable settlement for you.
LEARN MORE

External Reviews

If a health plan determines that services provided to a plan enrollee do not qualify for coverage with the surprise billing and cost-sharing protections of the No Surprises Act, the the enrollee can request an External Review of that decision. HHC Group, a URAC accredited Independent Review Organization conducts external reviews to determine whether health plans are complying with the surprise billing and cost-sharing protections under the No Surprises Act.

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Maximizing Client Savings Since 1995

H.H.C. Group is uniquely well qualified to provide this service given its:
  • 3 decades 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;
  • Highly qualified 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!

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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.