EP 158: No Surprises Act, Out-of-Network Bills, and the Independent Dispute Resolution Process

NFP's Insights from the Experts

In this episode, Suzanne Spradley and Chase Cannon discuss the No Surprises Act (NSA) and its impact on out-of-network (OON) billing, with the independent dispute resolution (IDR) process at its core. Suzanne starts with an outline of the NSA and OON billing, how surprise bills arise, and how the IDR process is meant to help with carrier and provider disputes on bill payment amounts. Suzanne and Chase discuss CMS’s involvement and the data gathered, shedding light on how IDR entities are selected, how disputes are handled, who’s winning, and the amounts being paid. The two close with a discussion of the fairness of the process and the impact on healthcare costs for employers and their group health plans.