Surprise Billing Legislation Passes

Advanced Reimbursement Solutions assists patients and physicians with medical billing reimbursements. As part of its corporate mission, Advanced Reimbursement Solutions advocates for pro-patient, pro-physician healthcare reform. Legislators addressed one area of healthcare reform by passing a law related to surprise billing in December 2020.

Surprise billing occurs when a medical provider sends a bill to a patient for a service that the patient thought would be covered by insurance. This can leave a patient with a significant amount of debt. For example, a patient may use an in-network facility but receive care from an out-of-network provider (i.e., an anesthesiologist). If the out-of-network provider cannot collect the full amount of care from the insurer, the patient is billed directly.

A nationwide ban on surprise billing passed as part of a COVID-19 relief package. Providers will now have to contact insurers to work out payment. The new law will not take effect until 2022 and applies to air ambulances (not ground), hospitals, and doctors.

Advanced Reimbursement Solutions holds insurance carriers accountable to appropriately administer the benefits patients pay for, and communicate with them directly on behalf of healthcare providers and patients. Through their proprietary redetermination process, understanding of applicable state and federal law, and negotiation processes, providers and patients are alleviated of the administrative burden, and able to focus on better medical treatment.