Starting today January 1st, 2022 many ASCs will have to comply with aspects of the No Surprises Act, a controversial measure aimed to end surprise medical bills for emergency and scheduled care.
Here are five things ASCs should know, according to December piece in ASC Focus:
1. ASCs are required to provide a good faith estimate to uninsured and self-pay patients. The estimate must include expected charges for items or services, as well as items or services that may be provided by other facilities.
2. The good faith estimate should use clear and understandable language and include an itemized list of each item or service, grouped by each provider offering care. Providers must display information regarding the availability of a good faith estimate on websites, in the office and on site where scheduling occurs.
3. The convening provider, in many cases the ASC, who received the initial request for a good faith estimate is responsible for collecting estimates from co-providers.
4. The estimate must be provided within one business day after scheduling (when the service is scheduled at least three business days in advance) or no later than three business days after scheduling (when the service is scheduled at least 10 business days in advance). For uninsured or self-pay patients, it must be provided within three business days after the consumer who has not yet scheduled requests a good faith estimate.
5. If a patient receives a good faith estimate, and then is billed for at least $400 higher than the good faith estimate, the patient can begin an independent dispute resolution process to determine the payment amount.