HFMA: New Surprise Billing Regulations - Assessing Patient Network Status

Nick HutJanuary 10, 2022

Man surprised at piece of paper
  • With new surprise billing regulations in place, providers should ensure they have efficient processes for gauging whether a patient is in-network.
  • For some providers, the task may prove to be more trouble than it’s worth in terms of opportunities to balance-bill patients.
  • The new regulations make communication between providers and insurers even more important.

Heading into the Jan. 1 implementation date for new surprise billing regulations, a few issues emerged as pain points for providers trying to adjust to the new rules.


An obvious concern involved the requirement to provide good-faith price estimates to uninsured and self-pay patients ahead of scheduled services, but other challenges loomed as well.  


“Part of the administrative burden that patients had been taking on is now going to fall on providers,” said Kathryn Beard, regulatory compliance manager with R1 RCM.


Read the full article here.

Author Bio: Nick Hut is a senior editor with HFMA, Westchester, Ill.