Updated: Feb 2, 2022
As of January 1, 2022 the No Surprise Act will take effect.
The NSA protects consumers from "surprise" medical debt from services. On July 1, 2021 our government and through the U.S. Departments of Health and Human Services (HHS), Labor, and the Treasury, as well as the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule with comment period that will restrict surprise billing for patients in job-based and individual health plans and who get emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.
What is a surprise medical bill?
When a person has a medical service from an out of network provider the provider will usually bill them a difference of what their insurance didn't pay. This is known as “balance billing.” An unexpected balance bill is called a surprise bill.
This rule protects patients from surprise bills under certain circumstances.
What are the new changes if I have health insurance?
If you get health coverage through your employer, a Health Insurance Marketplace®, or an individual health insurance plan you purchase directly from an insurance company, these new rules will:
Ban surprise bills for most emergency services, even if you get them out-of-network and without approval beforehand (prior authorization).
Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services.
Ban out-of-network charges and balance bills for certain additional services (like anesthesiology or radiology) furnished by out-of-network providers as part of a patient’s visit to an in-network facility.
Require that health care providers and facilities give you an easy-to-understand notice explaining the applicable billing protections, who to contact if you have concerns that a provider or facility has violated the protections, and that patient consent is required to waive billing protections (i.e., you must receive notice of and consent to being balance billed by an out-of-network provider).
Who will benefit from this rule?
People with insurance through their employer (including a federal, state, or local government), or through the federal Marketplaces, state-based Marketplaces, or directly through an individual market health insurance issuer.
Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE. already prohibit balance billing.
How does this rule help with credit reporting?
Over 70% of credit reports have errors reporting with 3rd party collections being the most. When disputing errors on your credit report 3rd party creditors have to follow certain laws and unfortunately most do not. These laws include the Health Insurance Portability and Accountability Act (HIPAA) Fair Debt Collection Practices Act (FDCPA) the Fair Credit Reporting Act ("FCRA"), Truth in Lending Act ("TILA"), Fair Credit Billing Act ("FCBA"), Dodd-Frank Act (UDAAP) Fair Debt Collection Practices Act (FDCPA) and now the No Surprise Act (NSA). When creditors violate these laws it can assist in the removal of Medical collections from your credit report.
Knowing your credit score is very important especially in today's society where credit can determine your employment and quality of living. Negative items will cause denials and low score ratings for consumers. At Valiant Credit Services we specialize in helping clients remove negative items through our credit repair services and also improve our clients scores as part of the credit education process. Contact us today to get clarity on your credit report and credit score. You can Schedule a FREE consultation with a Senior Credit Consultant today. CLICK BOOK NOW OR CALL 866-373-1377.