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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

End No Surprise Act Frustration

H.H.C. Group's Surprise Bill Resolution Assistance Service (SBRAS) is designed to enable payers and providers impacted by the No Surprises Act to resolve claims payments and avoid arbitration . The Act bans surprise billing for emergency services, regardless of where they are provided. Additionally, it 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 for both the provider and payor when a payor receives an unexpected, out-of-network bill for payment. HHC Group helps both parties by establishing an 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 and avoid the uncertainty of a decision by an Independent Dispute Resolution entity.

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 for an appropriate amount and avoid the cost and risk of going to arbitration. We've successfully negotiated reasonable settlements on tens of thousands of claims.
If the payor has remitted the QPA to the provider and they have rejected or questioned payment, both parties can still avoid the risk of potentially expensive arbitration. How? By having HHC Group negotiate a settlement on your behalf during the 30-business day Open Negotiation Period.
Even after the 30-day Open Negotiation period and the filing by one of the parties to enter the Independent Dispute Resolution process, we will keep negotiating to achieve a settlement acceptable to both parties.
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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 for an appropriate amount and avoid the cost and risk of going to arbitration. We've successfully negotiated reasonable settlements on tens of thousands of claims.
LEARN MORE

Open Negotiation
Second 30 Days

Negotiation
If the payor has remitted the QPA to the provider and they have rejected or questioned payment, both parties can still avoid the risk of potentially expensive arbitration. How? By having HHC Group negotiate a settlement on your behalf during the 30-business day Open Negotiation Period.
LEARN MORE

IDRE Arbitration Period

Negotation
Even after the 30-day Open Negotiation period and the filing by one of the parties to enter the Independent Dispute Resolution process, we will keep negotiating to achieve a settlement acceptable to both parties.
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 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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Achieving Fair Settlements 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.
  • 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.