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Avoid No Surprise Act Violation by Outsourcing Medical Billing4 min read

Outsourcing Medical Billing
Outsourcing medical billing helps healthcare providers to avoid No Surprises Act violations, maximize profits, and make informed decisions.

Don’t let your practice fall behind with the growing number of healthcare policies and procedures. The No Surprise Act (NSA) came as a surprise for many physicians. The implementation of the No surprise Act has led to many confusions among healthcare professionals. By outsourcing medical billing, you can get more done with less stress. The best way to avoid No surprise Act violations is by outsourcing your billing. Outsource medical billing companies are a great alternative to the high costs associated with traditional medical practice.

What is the No Surprise Act?

In January 2022, the No Surprise Act was passed to protect patients from unexpected out-of-pocket costs. The No Surprise Act regulates medical billing accounts to reduce prominent surprise billing for consumers. Violations of the No Surprise Act (NSA) can lead to hefty fines and negative press for physicians and their practices. A good-faith estimate of the cost of care must also be given by medical institutions to uninsured individuals, according to the Act.

Ancillary Services and Self-Referrals

If a patient has already received treatment from a medical facility, not in their insurance network, they may be required to pay for it out of pocket. For this law to apply, however, the provider must provide you a good-faith estimate amount before making any payment arrangements with them. Similarly, they must disclose the charges for “ancillary services, ” including X-rays, lab tests, and ultrasounds.

How Will This Affect Your Practice?

The new law’s provisions and how they would apply to medical establishments are the healthcare industry’s focus these days.  Additionally, billing departments have to educate themselves on the patient’s rights and compliance with the facility. According to the No Surprises Act, physicians and hospitals cannot charge their patients for treatments more than the in-network cost-sharing rate.

Consumers have the right to complain if they believe their doctor, clinic, or hospital did not follow the correct billing method as required by the NSA. If the complaint is legitimate, there might be a fine of up to $10,000. Doctors and healthcare practices are still navigating the new procedure. The information is intricate, developing, and changing. Medical offices are still dealing with the intricacy of the Act and are anxious about potential violations. Any error in the claims or incorrect information can cause you to put a lot of money on the table.

How Can Outsourcing Medical Billing Help?

Outsourced medical billing is a great way to increase your profits. Why? Because you can save money on administrative costs and minimize the chances of errors. An outsourced medical billing company can help you save time and money. Here are some reasons how:

  • You don’t have to stay abreast of the latest changes in Medicare, Medicaid, and federal laws.
  • You can focus on your core practice instead of spending time on paperwork for billing and coding.
  • Your staff can focus on patient care rather than dealing with hospital claim processors.
  • You’ll receive an accurate, detailed analysis of your practice’s financial performance. This way, you can make informed decisions about how to improve it.
  • It is an affordable way to handle your medical billing process.
  • It can save you money by reducing the number of people employed in medical billing.
  • You can eliminate the risk of human error by outsourcing medical billing as they may implement an automated system. 
  • Outsourced medical billing company usually has more experience and knowledge than other staff members handling this task.

Tips to Optimize outsource medical billing services

As the rules and regulations are changing, outsourcing billing services also needs to stay at par. The increased scrutiny demands greater attention to each record. Here are some tips to keep their medical billing systems in tip-top shape:

1- Keep Track of all the Details of your Patients’ care:

You may want to hire a medical biller who specializes in this type of work instead of one who just knows how to file claims.

2- Leverage Technology:

A well-trained outsourcing medical biller can use technology to track down information that you might otherwise have trouble finding manually. This can help you ensure that your patient’s bills are accurate and complete.

3- Insure Out-of-Network Patients:

An outsourced medical billing company may help patients to get insured by the insurance providers for their services.

Medical billing is complicated for a reason. Each patient has his/her own insurance policy and procedures, which change from year to year. There are several different managed care plans in the United States, which are a lot of moving parts to keep track of.  Outsourcing your medical claims can be a smart move and can save you both time and money. By outsourcing billing to reputed companies like Transcure, you can ensure your compliance with the appropriate rules and regulations.

Andrew Mark
Andrew Mark
As a healthcare IT expert, I bring extensive experience in revenue cycle management (RCM), medical billing, and coding. I am passionate about simplifying complex healthcare processes and empowering providers with efficient solutions.



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