Surprise Billing Resource Center

Surprise Billing Resource Center

Effective January 1, 2022, consumers have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. The No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing for services received from out-of-network providers.

The Quadax Resource Center is here to help keep you up to date on the latest regulations.

Helping to protect people from surprise medical bills

CMS No Surprises Act Website

{NEW} On Friday, April 15, 2022 the Federal Independent Dispute Resolution (IDR) Portal Launched.

Review rules and fact sheets on what No Surprises rules cover, and get additional provider resources with more information. Learn how out-of-network payment disputes between providers and health plans will be decided, apply to become a dispute resolution entity, or submit feedback on applicants.

Podcasts and Transcripts

CMS Open Door Forums

CMS sponsors regularly scheduled “Open Door Forums” providing an opportunity for live dialogue between CMS and the stakeholder community at large. These forums are intended for all stakeholders who interact with CMS or work with consumers who rely on services that CMS provides. Access the most recent NSA forums under the heading Special, Open Door Forums (ODF).

No Surprises Act Resource Center

Surprise Medical Billing News Center: Bulletins, FAQs, and Webinars

Toolkit for Physicians: Preparing for Implementation of the NSA

No Surprises Act Resources: Community Forum, News, and Podcasts

Infographic: No Surprises Act – Good Faith Estimates Workplan

Surprise Billing Articles, Bulletins, Fact Sheets, Webinars

Date

Article

Source

2/16/2024

Surprise billing disputes continue to far outpace federal estimates: CMS

11/8/2023

No Surprises Act (NSA) Toolkit for Consumer Advocates

10/27/2023

Biden-Harris Administration Advances Efforts to Improve the Surprise Billing Payment Dispute Process

7/12/2023

First Annual No Surprises Act Report Released

7/7/2023

Labor, HHS and Treasury release new No Surprises Act and Transparency in Coverage FAQs

6/15/2023

No Surprises Act website for consumers

5/15/2023

Independent Dispute Resolution Case Load 14X More Than Expected

4/19/2023

Experts Assess the Effects of the No Surprises Act on Surprise Billing

3/20/2023

CMS Says All Payment Determinations Under No Surprises Act Must Resume

3/9/2023

Federal Court Strikes Down No Surprises Act Dispute Resolution Rules

2/24/2023

CMS instructs some NSA billing arbitration decisions to resume following court-ordered pause

2/14/2023

CMS halts, recalls billing arbitration decisions after Texas court vacates guidance

1/31/2023

CMS Arbitration Backlog, Fee Hike Add to Labs' Surprise Billing Challenges

1/26/2023

CMS Increases Federal IDR Arbitration Fee

1/18/2023

No Surprises Act Payment Disputes Are Getting Out of Hand, CMS Says

1/16/2023

Most Disputed Claims Included Emergency Department Codes, Says IDR Report

1/13/2023

Chart Regarding Applicability of the Federal Independent Dispute Resolution (IDR) Process in Bifurcated States  (PDF)

1/13/2023

Chart for Determining the Applicability for the
Federal Independent Dispute Resolution (IDR) Process (PDF)

1/5/2023

Top No Surprises Act disputes by type of CPT code

1/4/2023

The portal to resolve surprise bills has been inundated with disputes — SCP Health tops the list

1/4/2023

Most closed No Surprises Act disputes were deemed ineligible

1/3/2023

Federal IDR Process Faces More Disputes Than Expected, Backlog Growing

12/12/2022

Struggling With GFEs? Revenue Cycle Leaders Will See Needed Relief

12/6/2022

6 things to know about the 1st year of the No Surprises Act

12/2/2022

CMS gives providers breathing room on looming advanced good faith cost estimates

11/17/2022

5 Ways to Reduce No Surprises Act Burdens

11/1/2022

Agencies release No Surprises Act guidance on independent dispute resolution process, fees

10/25/2022

Some State Surprise Billing Resolution Processes Favor Providers

10/24/2022

Patients Still Receive Surprise Medical Bills, Including for Medical Laboratory Testing, Despite Enactment of Federal No Surprises Act That Became Law on Jan. 1, 2022

10/12/2022

MGMA survey: New good faith estimates causing extreme burdens for physician practices

9/28/2022

CMS Urged to Lighten Rev Cycle Staff Burden

9/27/2022

AHA, AMA Dismiss Federal Surprise Billing Case, But Remain Concerned

9/27/2022

Good Faith Estimates - What Pathologists Need to Know (Webinar)

9/23/2022

No Surprises Act Could Lead to Uptick in Emergency Department Visits

9/16/2022

Request for Information; Advanced Explanation of Benefits and Good Faith Estimate for Covered Individuals

9/13/2022

State Surprise Billing Laws Impact Out-of-Network Provider Charges

8/19/2022

NSA FAQs 

8/19/2022

HHS and federal departments issue final rules to clarify No Surprises Act dispute resolution

8/16/2022

CMS Releases Guidance on Independent Dispute Resolution Process

8/9/2022

CAP Releases Good Faith Estimate Toolkit for Pathologists

8/8/2022

Physician practices seek more time to comply with No Surprises rules

7/2/2022

Surprise billing rule also strikes down insurer ED policies

6/30/2022

No Surprises Act: Fact Sheets for Your Patients

6/9/2022

Atlanta system 1st in US to face CMS fines for price transparency violations

6/8/2022

Price transparency noncompliance rampant, especially in concentrated markets, rural areas

6/8/2022

AMGA Asks CMS to Amend Good Faith Estimate Policy, Guidance

6/7/2022

CMS urged to extend enforcement discretion for No Surprises Act requirement

5/24/2022

No Surprises Act May Have Blocked 2M Surprise Billing Claims

5/19/2022

MGMA Recomends Priority Changes to Improve IDR Portal

5/5/2022

HHS' surprise-billing appeal on hold

5/3/2022

Air Ambulance Provider Sues Over No Surprises Act

4/29/2022

Price Transparency Rule is a Burden for Hospitals

4/29/2022

AMA Guide for Physicians: Disputing Out-of Network Payments Using the No Surprises Act Independent Dispute Resolution Process

4/28/2022

Webinar: Out-of-network payment process under the No Suprises Act

4/27/2022

CMS revises its guidance on the independent dispute resolution process

4/26/2022

HHS appealing Texas judge's surprise billing ruling

4/25/2022

HHS to appeal Texas ruling that struck down key parts of surprise billing rule

4/12/2022

Federal Independent Dispute Resolution (IDR) Process Guidance for Certified IDR Entities

4/7/2022

AHA, AMA Ask Court to Vacate IDR Provisions in Surprise Billing Rule

4/7/2022

Surprise billing compliance 'very daunting,' regulatory experts say

4/7/2022

How The No Surprises Act Seeks to Change Surprise Billing

4/7/2022

FAQs for Providers about the No Surprises Rules

3/18/2022

No Surprises Act Quiz:

Test your understanding

of the law

3/11/2022

WEDI Voices Concerns About Good Faith Estimates Implementation

3/10/2022

Good Faith Estimate Requirement Lays Bare Rev Cycle Woes

3/9/2022

AHA: Good Faith Estimates Create Administrative Burden for Hospitals

3/7/2022

Surprise Billing Ban Opens Door for CFPB to Curb Medical Debt

3/7/2022

Feds consider next steps for No Surprises Act

2/28/2022

CMS Provides Update on Good Faith Estimate Requirements

2/24/2022

Judge orders key parts of surprise billing arbitration rule vacated, handing providers crucial win

1/28/2022

AMA Advocacy Insights webinar series: Implementing the No Surprises Act

1/14/2022

Detailed Summary of No Surprises Act

1/14/2022

The No Surprises Act is in effect. What physicians need to know.

1/11/2022

Medical organizations continue to fight surprise-billing dispute process: 5 details

1/11/2022

HHS Releases Patient-Provider Dispute Resolution Guidance from No Surprises Act

1/7/2022

Before New Ban, the Prevalence of Surprise Bills

1/2/2022

The No Surprises Act: Beyond the emergency department, a silver lining of patient engagement

1/1/2022

A New Ban on Surprise Medical Bills Starts Today

12/31/2021

Establishing the Building Blocks for Price Transparency - Industry Guidance on Provider to Payer Approaches for
Good Faith Estimate Exchanges

12/31/2021

Telemedicine Providers Take Note – The No Surprises Act Is Effective January 1, 2022

12/15/2021

No Surprises Act Resources

12/14/2021

What physicians need to know about the No Surprises Act

12/13/2021

4 Barriers Providers Face with Preventing Surprise Medical Bills

12/10/2021

No Surprises Act Implementation: What to Expect in 2022

12/9/2021

Hospital and doctor groups sue Biden officials over surprise billing rules