Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

Health Insurance

Provider Directory Requirements of the No Surprises Act

Among the lesser known provisions of the No Surprises Act are those that seek to improve the accuracy of in-network provider directories maintained by insurance plans. While more complete rulemaking to address provider directories is expected later in 2022, the No Surprises Act laid out the general groundwork for both payers and providers to tackle the problem of out-of-date and inaccurate directories. The law also includes some protection for patients who rely on bad information in a directory and end up with a surprise out-of-network bill. READ MORE

Outsourced Billing Solutions for Hospital-Owned Physician Practices

One way to ensure hospital-owned physician practices are maximizing reimbursement is to outsource the billing of professional medical claims to medical billing companies who specialize in physician billing. Such outsourcing offers several key advantages for hospitals, as well as other corporate entities. Here’s why. READ MORE

Judge Orders Changes to the Independent Dispute Resolution Process

A February ruling by Judge Jeremy D. Kernodle in the U.S. District Court for the Eastern District of Texas found portions of the independent dispute resolution process, established by the Departments of Health and Human Services, Labor, and Treasury during last year’s surprise billing rulemaking, to be inconsistent with the No Surprises Act. READ MORE

Avoiding Provider Enrollment Delays

While bringing on new physicians or other clinicians is an important part of building your medical practice, enrolling them with commercial and government payers can be time consuming…and costly. The tedious process leaves plenty of room for error and delay, both of which can mean missed opportunity for payment. As you work through enrolling providers, here are a few tips to ensure a timely and successful process. READ MORE

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